Writing an Appeal
- Stick to the facts. Even though your emotional response is strong,your appeal needs to be as factual as possible.
- Identify what you are appealing.
- Include all provider required information such as date of service, health provider information, claim and policy number, etc.
- Use the same terminology as the insurance provider throughout your appeal, especially when stating why their denial should be overturned(Hint:Refer to your benefit or policy packet).
- State the resolution you are seeking in measurable terms. For example, you may ask for full coverage for 2 cycles of IVF within 30 days.
- Inform the insurance provider of what next steps you are prepared to make should they uphold the denial. For example, you may file a complaint with the Division of Insurance within your state.
- Attach as much supportive information as possible to your appeal.
You will find studies, facts and resources to use within the “Supportive Information” page.