Louisiana Special Reimbursement Consideration Appeal

State:
Louisiana
Control #:
LA-SKU-0648
Format:
PDF
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Description

Special Reimbursement Consideration Appeal

Louisiana Special Reimbursement Consideration Appeal is a type of appeal that is filed with the Louisiana Department of Health (LDH) when an individual or entity has an outstanding debt for medical expenses incurred in the state of Louisiana. The appeal is used to obtain a reimbursement for medical expenses that are not covered by the individual’s health plan or insurer. There are two types of Louisiana Special Reimbursement Consideration Appeals: appeals for individuals (SR-1) and appeals for entities (SR-2). The SR-1 appeal is for individuals who have an outstanding debt for medical expenses that are not covered by their health plan or insurer, while the SR-2 appeal is for entities, such as medical providers, who have an outstanding debt for services provided in the state of Louisiana. Both types of appeals must include detailed documentation of the applicable expenses, and copies of all related billing statements and proof of payment.

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Louisiana Special Reimbursement Consideration Appeal