How to Write a Letter of Appeal to Your Insurance Company

I recently published an article on what to do when an insurance company denies your claim. I had mentioned that one of the first things you can do is write a letter of appeal to the insurance company. What I did not include was how to write such a letter. So I figured I would use the letter that I wrote as an example. Of course I am going to change some of the details like my insurance information and things like that. Regardless of the things that are changed I think you should pretty much get the idea of how you should write this.

After you have written a letter of appeal you should also make sure that you mail it certified so that it requires a signature. One problem that people seem to run into when trying to resolve certain issues via the mail is that certain companies often claim that they never received such a letter. Mailing it certified not only allows you to track it and see when they received the letter, but also who signed for it. It may cost a little extra money to send it out that way, but it's definitely worth saving the hassle that can come about if you have no proof that a company received your letter

Here is an example of what I wrote as a letter of appeal to my insurance company:

July 25, 2007

My insurance Company Representative
Name of my insurance
Insurance companies street address
City, State, and the zip code

Re: Request for reconsideration of coverage denial.

Jill Ermer
My insurance name PPO
ID# ABC0000D0000
Bin# 123456

Dear Sir or Madam,

After receiving a bill from Blank Radiology Associates LLC I have decided to appeal your decision to deny coverage of my recommended treatment plans for both my CT Thorax w/dye on June 11^th and trans-vaginal ultrasound on June 4^th.

In the billing code 10 (per your insurance carrier, theses services were not medically necessary. Payment was denied) was given for cat scan w/dye done on June 11^th at Blank Hospital in Buffalo NY in which treatment was ordered by Dr. Jane Doe. Also code 11 (per your insurance carrier these services were for a pre-existing condition. Payment was denied) for my Transvaginal ultra-sound performed on June 4^th ordered by Doctor John Doe at Blank Hospital in Buffalo NY.