Appealing a denied claim

If your insurer denies a claim, you generally have the right to an internal appeal, and in many cases an independent external review. Many appeals succeed.

Steps

1. Read the denial letter: the reason and the deadline to appeal
2. Call your insurer to understand the reason; sometimes it's a coding error
3. Ask your doctor's office for a letter of medical necessity if relevant
4. File the appeal in writing before the deadline, with copies of supporting documents
5. If it's denied again, ask about external review

Get help

Your state insurance department or consumer assistance program can help. See HealthCare.gov for appeal rights.

General educational information, not medical or insurance advice. Dime and Dollar isn't paid by any insurer, provider, pharmacy or discount program.