Your appeal should include:

• an appeal letter
• a letter from your doctor (and specialist if appropriate) addressing specifics of your case (if information from your provider describing your need for coverage is necessary for your appeal)
• any pertinent information from your medical records that would support your case

The Appeal Letter should include:

• Your plan identification numbers (policy number, group number, claim number)
• The reason for the denial that they explained in the denial letter
• A brief history of the illness and necessary treatment
• Why you believe the decision was wrong
• What you are asking the managed care plan to do
• A request for the insurer's file on the claim

More about Internal Appeals Process

Other Related Links:

Determine the Problem

3 Step Complaint Process

Internal Appeals Process

External Appeals Process

Download Consent Statement