(Transcribed from the original)

Always First In Health Plans

World Houston Plaza
15710 JFK Boulevard, Suite 500
Houston, TX 77032
(281) 986-8000



August 31, 1998


Employee : Ronald Martin
Soc. Sec. No. : XXX-XX-XXXX
Employer : S & A Restaurant Corp./H2823

Dear Dr. Xxxxxx:

You August 19, 1998 request for pre-authorization of benefits for Diagnostic Lumbar Puncture, MRI Brain, MRI Spine and IV Rocephin therapy has been referred to our office for response.

First Health is unable to provide pre authorization of benefits except for non scheduled surgical procedures. We will be happy to review all information retrospecively provided that all pertinent medical records and test results are submitted with the charges for the services rendered.

We regret that this determination is not more favorable.


Sincerely,



First Health

Appeals Department

JC

CC: Linda Farina, S & A Restaurant Corp.