Dear Mr. Napier –
We have received your claim seeking reimbursement for several visits to Gotham Dermatologic Associates. According to their records, these appointments were to correct anomalous facial pigmentation attributed to caustic chemical exposure.
After reviewing your paperwork, we have concluded that these treatments are cosmetic, and therefore elective. As you are doubtless aware, services of this kind are not covered under the terms of your plan.
We value you as a customer, and look forward to serving you in the future.
Dear Mr. Cobblepot –
Thank you for contacting our benefits specialists about the terms of your individual health plan. As always, we are eager to assist you.
With regard to the specifics of your inquiry, I regret to inform you that the interventions you are seeking would not be covered. Adult enrollees in your plan are not covered for correction of congenital anomalies, such as your bilateral polysyndactyly.
I have taken the liberty of enclosing materials provided by several local charities, any of which might take a benevolent interest in your case. I wish you the best of luck, and look forward to being of further assistance.
Dear Mr. Dent –
We are writing in regard to your correspondence requesting coverage for upcoming surgery at the Greater Gotham Plastic and Reconstructive Surgery Center. From the documentation they have submitted, we see that you are scheduled to have corrective surgery following severe unilateral chemical burns to the face.
Unfortunately, we are cannot process your paperwork due to the erratic manner in which it was completed. Half of the forms are meticulously typed-in and include scrupulous detail, while the remainder (sometimes starting halfway down the same page) are covered with an incoherent, barely legible scrawl, laced with profanities and threats. (Several members of our clerical staff have submitted complaints to our human resources department, and we really must insist that all future correspondence be limited to civil language.) We are unable to approve your request for coverage based upon the materials as submitted.
Given the scheduling of your procedure, we regret that we will be unable to process substitute paperwork in time to guarantee coverage. We wish you a speedy recovery, and look forward to many opportunities to serve you in the future.
Billy D. Eckhart
Dear Ms. Kyle –
We have received statements from Gotham City General Hospital regarding treatment you received in their emergency department. According to the records submitted, you were treated for hyperextension injuries to the cervical spine, a chemical burn to the upper deltoid, numerous contusions of the trunk and extremities, and two gunshot wounds.
While emergency medical care is certainly part of our standard coverage, we are unable to remit payment for this visit. Your coverage was provided as an employee of Shrek Industrial Holdings. Inc. According to records recently submitted by their personnel department, you are deceased. Documentation of your demise was completed and submitted by your employer, Max Shrek, who reportedly witnessed the event personally.
If you believe this information to be in error, please have Mr. Shrek submit an affidavit retracting his previous statement. Once we are in receipt of the appropriate materials, we would be happy to reconsider payment for your treatment.
Thank you for choosing Gotham Mutual for your health insurance needs.
Dear Dr. Crane –
Thank you for submitting the additional paperwork requested by our office. We have evaluated your request to extend the number of outpatient counseling and treatment appointments for several of your patients suffering from various anxiety, panic or phobic disorders.
Upon review of the records and supplemental materials you provided, we are pleased to approve an additional three months of treatment for the patients listed (see attached spreadsheet). We agree that their disorders warrant further therapy, and concur with the management plans you detailed in your reports. Please feel free to have your staff contact them to schedule appointments at your convenience.
As always, we are glad to be partnering with you to provide care for Gotham’s citizens.
Mental Health Benefits Coordinator