WOL (Waiver of Liability)

A medical liability waiver is an advance written notice to the beneficiary used by medical professionals when the services being provided are found not to be medically necessary. 

A completed and signed copy of the Waiver of Liability statement is used to request a reconsideration of the plan’s denial of payment.  It must be signed by the patient or their legal representative. When the provider is appealing on their own behalf and agrees not to bill the member if  the decision was upheld . Also, this form is required for a non-contracted provider when submitting an appeal.

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