| Claim denied for Medical Records | ||
| 1 | Date when the claim was received. | |
| 2 | Date when the claim was denied | |
| 3 | May I know why you required Medical Records for this service | |
| 4 | May I know what type of Medical Records required to process the claim | |
| 5 | May I know the appeal limit and address | |
| 6 | May I know the fax# to fax the claim with MR notes and whose attention it should be | |
| 7 | May I know the claim# | |
| 8 | May I know the Call reference# |
