Sometimes, decisions made are made improperly or based on erroneous information. On such occasions, a letter of appeal is appropriate. The following letter is an example of an appeal to an insurance company that denied a client his or expected benefits.
Name
Street Address
City, State, Zip
Date MM/DD/YYYY
Dear Claims Review Department:
I am writing about a claim sent to you by [Medical Provider] for [patient]. The charges were entered on [date], and they totaled [dollar amount]. [Healthcare Provider] has denied payment for this procedure, stating that the home health agency was not licensed when the procedure was conducted.
The State of Kansas does not require a home health agency to be a licensed provider. Home health agency visits are covered under my insurance plan. Therefore, I request that you reconsider your refusal to pay for this procedure. I have attached written documentation that supports my position.
Please reconsider this denial. I can supply more information if necessary or helpful; let me know what other pertinent information you may need. Thank you for your time and for your help in this matter.
Sincerely,
Download Sample Letter of Appeal In Word Format