Health Insurance Appeal Letter

Out of all the sorts of insurances, the health insurance can easily be stated as one of the most uncalled for. However, it can be planned beforehand in case the patient is suffering through an inherent disease and has medical examinations at regular intervals. With the older family members, the routine is often set and the doctors have a proper schedule for them.

It is nothing novel or unusual for the insurance companies to entertain the clients who have medical issues, however, the homework on your own end has to be more than thorough.

A few elements when writing the appeal for health insurance which do not allow any provision for forgetting is your full name and the details of your policy. In case you are writing for the revision of your denied medical insurance then state the reason for the denial.

Make it clear that you intend to appeal the denial. Specify any records of your previous treatment while holding the same policy and also records that are essential in getting your treatment approved.

Do not forget to give your complete and accurate contact details. Not accessible when the denial is about to be lifted is the last thing you would want when stuck in a medical crisis.

Instructions

  • 1

    Sample of the Health Insurance Appeal Letter


    April 13, 2011
    Frank Meyers
    25th East Street, Round Boulevard,
    Chicago City, 3647
    5256-768-980
    Wiki Policy Insurance
    Crammed Street, Busted Corner,
    Chicago, 65775

    Re:       Patient: Serena Bulls

    Policy Number: 6785986-B
    Treatment dates: September 12, 2011-December 14, 2011
    Billed Amount: $2,300

    Dear Mr. James,

    My mother has been visiting the hospital regularly for her therapy sessions and the physiotherapy, however, this once the doctors have suggested that with get her admitted for a week. In her current state, it is crucial for her to stay under constant supervision of the professionals.

    I am appealing on her behalf so that I can coordinate the hospital schedule with the insurance payment.

    Anxiously waiting for your response,

    Frank Meyers

  • 2

    Template of the Health Insurance Appeal Letter


    Date

    Your name
    Your address
    Your city, state, ZIP
    Your phone number

    Attn: Claims Director name
    Claims Director title

    Name of insurance company
    Insurance company address
    City, state, ZIP

    Re: Patient: patient’s full name
    Policy Number:
    policy number
    Treatment dates:
    list all individual dates and date ranges of treatment
    Billed Amount:
    total amount billed by your doctor(s)

    Dear (insert name of Claims Director if possible),

    As the past records are indicative, my mother has been under the consulting supervision of the doctors since a while now and has to visit for medical examination at regular intervals.

    Her aggravated medical problems have led the doctors to suggest at least a week’s admission in the hospital. I was not prepared for this twist of routine and the following expenses so I would highly appreciate a positive response.

    Please kindly inform me timely so that I can coordinate the schedule with the doctors.

    Sincerely,

    Your signature
    Your typed name

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