Denial Resolution Tool

Denial Evidence Packet Builder

Turn a denial family into a controlled checklist for triage, evidence collection, resolution routing, and prevention.

Use de-identified facts only. Do not type or print patient names, Medicare identifiers, claim numbers, dates of birth, medical records, or other protected information into this public tool.

Denial family

Likely route

Appeal review

0 of 7 packet controls checked

Claim history suggests the beneficiary already received equipment that may serve the same medical purpose or has not met replacement requirements.

Triage checks

Identify prior code, supplier, service date, and ownership or rental status.Compare functions of the prior and new items.Check replacement and reasonable-useful-lifetime rules.

Evidence packet

Same-or-similar historyPrior item detailsRepair estimate or loss/damage evidenceClinical need for different functionality

Resolution sequence

01Correct beneficiary or code mismatch.
02Coordinate with the prior supplier or payer when history is wrong.
03Appeal a supported replacement with item-specific evidence.
04Use a valid notice and liability process when applicable.

Open full denial guide Plan deadline