Patient Letter Templates for SI Joint RF Ablation Non-Coverage Decisions🔒

Looking for assistance with informing your patients that their sacroiliac joint radiofrequency ablation (SIJ RFA) treatments are no longer covered by Medicare? IPSIS has created letter templates to help.

Intended to be used in conjunction with Advance Beneficiary Notices (ABN), which inform patients that procedures are not covered by Medicare and will have to be paid for out of pocket, these letter templates provide a brief explanation of the decision and encourage them to reach out to their Medicare Administrative Contractors to express their concerns about lack of coverage.

These letters are applicable to all US jurisdictions except those under Novitas and FirstCoast, which have not issued any new policies related to SIJ procedures. Use the links below to tailor the letter to your practice's needs.

Solo Practice Template 🔒
Group Practice Template 🔒

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