Why Was My Letter of Medical Necessity Denied?Updated 3 months ago
There are a few common reasons for denial:
Insufficient Supporting Research: The product you requested may not have enough supporting research demonstrating its effectiveness for your specific diagnosis. This is one of the primary reasons for denial in LMN cases.
Incomplete Information in the Qualification Survey: The information you provided in the qualification survey may not have been comprehensive enough to support your request. Specifically, if you only used the free text field without selecting the appropriate diagnosis or providing detailed information, the request may lack key details required for approval.
What Steps Can I Take to Resolve This?
If your LMN request was denied, consider taking the following actions to improve your chances:
Retake the Qualification Survey: If you only used the free text field in your original submission, we recommend retaking the survey. This time, be sure to select the option that best matches your diagnosis from the predefined choices. Providing a clearer and more specific response will help ensure that all relevant information is taken into account.
Provide Additional Details: In addition to selecting the correct diagnosis, be sure to provide any additional details in the free text section. This could include information about your condition, previous treatments, or any other factors that may help clarify the need for the product.
After Submission
Once you have updated your qualification survey, your request will be reviewed again. In many cases, this additional information may be sufficient to approve your LMN and move your purchase forward.