<p><DATE></p><p>Anthem BCBS Appeals Department 700 Broadway, Mail stop CO0104-0430 Denver, CO 80273</p><p>Explanation of Benefits: <CLAIM NUMBER></p><p>Dear Sir or Madam:</p><p>I am writing to request that you reconsider claim decision for my Afirma Thyroid FNA Analysis on <DATE OF SERVICE>. </p><p>Dr. <DOCTOR NAME>, biopsied my tumor and the pathology result was “indeterminate,” a classification that is not clearly benign or malignant. My physician recommended ordering the Afirma test as a next diagnostic step instead of proceeding immediately to surgery. </p><p>As a result of the Afirma test, my tumor was diagnosed as benign. The Afirma test was instrumental in clarifying my diagnosis and allowing me to avoid having surgery to remove my thyroid. I was also able to avoid life-long hormone replacement therapy due to the loss of my thyroid.</p><p>I am requesting that you reconsider my claim, and properly pay for Afirma. Veracyte has informed me that Anthem Blue Cross Blue Shield’s benefit coverage for the test was inadequate. Veracyte also shared that national insurance companies including several Blue Cross Blue Shield plans cover Afirma and pay for the test at rates exceeding $4,000 substantially reducing the amount owed by patients.</p><p>It is unfair that many Blue Cross Blue Shield plans and national insurance plans recognize the medical necessity of Afirma and cover a significant portion of the test while my insurance does not. Additionally, I find it unfair that you would arbitrarily subject me to such a large financial burden, especially in light of the fact that this test helped me avoid an unnecessary surgical procedure. Anthem Blue Cross Blue Shield has a network deficiency for Afirma which is considered medically necessary per national thyroid treatment guidelines. I am asking that you reconsider your decision and pay my claim in full for Afirma.</p><p>Please include myself and Flavia Beyer at Veracyte in all correspondence regarding my reconsideration request.</p><p>Sincerely, </p><p><MEMBER NAME></p><p>Subscriber ID: <MEMBER ID NUMBER></p>