Request for Allowable Fees

DOCUMENT   OVERVIEW:      This   document  may   be   used  as   a   tool   in   reimbursement   negotiations  
between   practices   and   participating   insurance   companies.      
 
 
  [date]     [inside  address]     To   Whom   It   May   Concern:     I   am  with   [name   of   practice].   We   have  b een  unable  to  locate  the  fee  allowables  for  the   following  CPT™   codes  in   our  files  [—].*    I  would  be  very  grateful  if  you  could  forward  this   information  to   me.  Our   fax  number   is  [fax  number]   and  our   email  address   is  [email].     Thank  you  for  your  assistance.     Sincerely,     [name]