Free appeal letter templates, for the denials you actually fight.

Medical necessity denials — CARC 50 (not deemed a medical necessity)

Timely filing denials — CARC 29 (time limit for filing expired)

Prior-auth denials — CARC 197 (precertification/authorization absent)

Bundling denials — CARC 97 (payment included in another service), NCCI edit pairs

E/M downcoding — payer reprices a 99214 to 99213 (or reduces the level), often silently; CARC 45 / no clear CARC

Non-covered service denials — CARC 96 (non-covered charge), CARC 204 (not covered under the plan)

COB denials — CARC 22 (may be covered by another payer per COB), CARC 23 (prior payer adjudication)

Denials fixed by resubmission — CARC 16 (missing/invalid information) and any denial resolved by a data or coding correction

Experimental/investigational denials — CARC 55 (procedure/service deemed experimental or investigational)

Provider-eligibility denials — CARC 185 (rendering provider not eligible), CARC B7 (not certified/eligible for this service), CARC 8 (procedure inconsistent with provider type)

Units-exceeded denials — CARC 151 (information doesn't support this many services), CARC 273 (coverage/frequency exceeded), Medically Unlikely Edits

Any first-level appeal where a denial-specific template doesn't fit — a starting frame for the initial reconsideration

Clinical denials worth a physician-to-physician conversation — medical necessity, experimental/investigational, and level-of-care denials

Upheld first-level denials — the escalation to a second-level internal appeal or an independent external review (IRO)