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Claim Denial Letter

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Insurance Document Intelligence

The world's best denial letter extraction

Transform denial management with intelligent document processing. Extract denial reasons, appeal deadlines, and missing information requirements automatically. Enable faster appeal responses and improve overturn rates.

claim-denial-letter.pdf

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JSON

letter_date

2024-03-08

claim_number

CLM-2024-567890

policy_number

HP-2024-123456

insurer_name

National Health Insurance

insurer_address

100 Insurance Tower, Chicago, IL 60601

member_name

Patricia Davis

member_id

PD456789

member_address

789 Oak Street, Milwaukee, WI 53201

date_of_service

2024-02-15

provider_name

Advanced Medical Specialists

procedure_code

27447

procedure_description

Total knee replacement

billed_amount

45000

denial_code

PR-001

denial_reason

Prior authorization required but not obtained

denial_explanation

The requested procedure requires prior authorization. Our records indicate that prior authorization was not obtained before the service was rendered.

appeal_deadline

2024-06-08

appeal_instructions

Submit written appeal with supporting documentation to Appeals Department

contact_phone

(800) 555-0100

contact_email

appeals@nhi.example.com

{ "letter_date": "2024-03-08", "claim_number": "CLM-2024-567890", "policy_number": "HP-2024-123456", "insurer_name": "National Health Insurance", "insurer_address": "100 Insurance Tower, Chicago, IL 60601", "member_name": "Patricia Davis", "member_id": "PD456789", "member_address": "789 Oak Street, Milwaukee, WI 53201", "date_of_service": "2024-02-15", "provider_name": "Advanced Medical Specialists", "procedure_code": "27447", "procedure_description": "Total knee replacement", "billed_amount": 45000, "denial_code": "PR-001", "denial_reason": "Prior authorization required but not obtained", "denial_explanation": "The requested procedure requires prior authorization. Our records indicate that prior authorization was not obtained before the service was rendered.", "appeal_deadline": "2024-06-08", "appeal_instructions": "Submit written appeal with supporting documentation to Appeals Department", "contact_phone": "(800) 555-0100", "contact_email": "appeals@nhi.example.com"}