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How to appeal a medical bill

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Please do not resubmit bills as this can delay the review process. Instead, use our online appeal function for quick and easy bill appeal.

Appeal Online

To appeal online, click the Sign in option in the top right corner. Then select Medical Provider to sign into the Provider Portal.

  1. Log in with your email and password
  2. Click the Search Bills tab and select the clinic Tax ID
  3. Enter the claim number, bill number, date range or EFT/check number
  4. Click the Search button
  5. Select the bill you want to appeal
  6. Click the Bill Detail tab
  7. Click on Appeal
  8. Provide the reason for the appeal and any additional comments in the text box
  9. Upload optional supporting documentation as an attachment or by dragging and dropping
  10. Click Done to close the window
  11. After uploading, select the file type: medical record, bill or attachment
  12. Click Submit Request
  13. A pop-up indicates the appeal was submitted and the bill detail will indicate the bill is in appeal
  14. You will receive an email indicating the bill appeal was received

Start your appeal

Appeal by Paper

If you wish to submit a paper appeal by mail:

Pinnacol Assurance

P.O. Box 469013

Denver, CO 80246

You may also fax an appeal to 303.361.5820 or email an appeal to billingsuccess@pinnacol.com.

All appeals must include the following information:

  1. A copy of the original or corrected bill
  2. A copy of the written notice or EOB received
  3. A statement of the specific item(s) contested
  4. Clear and persuasive supporting documentation or reason for the appeal
  5. Any available additional information requested in our written notice

Rules for appealing a medical bill

The Colorado Division of Workers’ Compensation requires billing appeals be received within 60 days of Pinnacol’s EOB date. Further, appeals must include clear and persuasive supporting documentation and/or reasons for the appeal in addition to any supplementary information we may have requested from you.

Questions?

Call us at 303.361.4940 or 888.852.2289 or email us at BillingSuccess@pinnacol.com.

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