Medterpret

Medicare Advantage

Help before a prior authorization, and after a denial or a bill, for plans from an insurance company.

Not affiliated with or endorsed by any government agency. Medterpret drafts letters and tracks deadlines. You sign and file.

  1. I have a test, scan or procedure coming up.

    Does my plan need prior authorization? What to ask for before the visit, so the visit doesn’t turn into a denial.

    Before the visit

  2. My plan denied the prior authorization.

    Track A: reconsideration within 60 days, expedited if care is pending. Ask your doctor for two things, the records and a sentence on why the test was needed. We draft the appeal when your plan’s notice states the specific reason for the denial. If it doesn’t, step one is a letter asking for it; plans must state the specific reason.

    Appeal a prior-auth denial

    Not affiliated with or endorsed by any government agency. Medterpret drafts letters and tracks deadlines. You sign and file.

  3. My plan denied the claim.

    Appeal a denial: Track B reconsideration within 60 days, then the IRE. Upload the denial, get a draft appeal letter tailored to why you were denied. Review, edit, sign and send.

    Appeal a denial

    Not affiliated with or endorsed by any government agency. Medterpret drafts letters and tracks deadlines. You sign and file.

    Appealing a skilled-nursing discharge? →

  5. How does my plan compare?

    Insurer scorecard: prior-authorization denial and overturn rates for the largest Medicare Advantage insurers.

    See the scorecard

Not affiliated with or endorsed by any government agency. Medterpret drafts letters and tracks deadlines. You sign and file.

How it works, by document

Which document do you have?

Test order

before the visit

1 · Show us
Snap a picture of the order.
2 · See what it says
Whether the diagnosis codes match Medicare’s coverage rules for each test.
3 · Take the next step
If the codes don’t match, double-check with your doctor before you go.

ABN

Advance Beneficiary Notice

Original Medicare only
1 · Show us
Snap a picture of the ABN.
2 · See what it says
What Medicare pays for those tests, and how large the lab’s markup is.
3 · Take the next step
Ask for a lower price. If the lab won’t come close, use Find a lab for one that will.

Denial letter

MSN, EOB or plan letter

1 · Show us
Snap a picture of the letter.
2 · See what it says
What your plan says about why, the deadline to act, and whether Medterpret thinks it’s worth acting on. All in plain English.
3 · Take the next step
If it’s worth it and you want our help, we draft an appeal letter tailored to the reasons you were denied. You review, edit, sign and send.

Bill

after the visit

1 · Show us
Snap a picture of the bill.
2 · See what it says
Their price against Medicare’s rate, and the gap you can use.
3 · Take the next step
Use Medicare’s rate and our negotiating tools to get a better deal. (GougeStop)

Tools