• Sample Letter of Medical Necessity
• Sample Letter of Appeal(Patient)
• Sample Letter of Appeal (Physician)

Sample Letter of Medical Necessity

It may be necessary for you to provide a payor with a letter of medical necessity to support your patient's need for Kineret^® therapy. The following is a sample letter of medical necessity. For assistance with medical necessity documentation, please call your reimbursement counselor at the Kineret^® Customer Call Center at 1-866-KINERET (1-866-546-3738).

Download Sample Letter of Medical Necessity (MS Word, 24 Kb)

Sample Letter of Appeal (Patient)

In some cases, a payor may overturn a claim denial over the phone. However, some payors will require a formal letter of appeal. Below is a sample letter of appeal that your patients can use, should any payors deny coverage for Kineret^®. If your patients are in need of further assistance in appealing a claim denial for Kineret^®, please refer them to your reimbursement counselor at the Kineret^® Customer Call Center at 1-866-KINERET (1-866-546-3738).

Download patient Sample Letter of Appeal (MS Word, 24 Kb)

Sample Letter of Appeal (Physician)

In some cases, a claim denial may be overturned after a phone call to the payor. However, some payors may require a formal letter of appeal from the prescriber. Below is a sample letter of appeal. For assistance in appealing claim denials for Kineret^®, please call the 1-866-KINERET (1-866-546-3738).

Download physician Sample Letter of Appeal (MS Word, 24 Kb)

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