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Denial Decoder & Appeal Builder
PAMS Access Toolkit
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1 · What does the denial say?

Pick every reason the letter lists. Many denials give more than one.

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Not a denial: Prior authorization expiredAn expired PA is not a denial. Start a new PA, usually through CoverMyMeds or by fax, with recent follow-up notes that show how the patient responded and a current severity score. Check whether the plan year also reset.
Pick one or more reasons above, or paste the letter. The next steps and the appeal letter will appear here.

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