OHA: Write an Appeal Lettter

Write an Appeal Lettter

After you have gathered all your information and have a basic knowledge of the illness and the insurance plan, you are ready to start the appeals process

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

Content Last Modified on 12/18/2012 1:40:02 AM