I am writing to appeal the denial of medical services provided to Mona Quitzon, who is a member of your health plan. Family Care POS 750 denied the claim submitted for emergency endotracheal intubation, rapid strep test, influenza assay performed on her, stating that the services were not covered under her plan. However, I would like to present evidence that these services were indeed medically necessary and should be considered for coverage.

Mona was diagnosed with acute respiratory infection, which required medical intervention. These tests and treatments were crucial in identifying the cause of her condition and providing appropriate therapy to alleviate her symptoms.

As per the American Medical Association, emergency medical services are defined as those that are provided to a patient with symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy. Mona’s condition clearly met these criteria, and the medical services provided to her were in line with the standard of care for such emergencies.

In conclusion, I kindly request that you reconsider the denial of Mona Quitzon’s claim. Thank you for your prompt attention to this matter.

Sincerely,
Jeremy Parkson