Tips for Appealing a Claim
If your health insurer has denied coverage for medical care you received, you have the right to appeal the claim, and ask that the company reverse that decision. You can be your own health care advocate. Follow these five steps:
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Review your policy and explanation of benefits.
Contact your insurer and keep detailed records of your contacts (copies of letters, time and date of conversations).
Request documentation from your doctor or employer to support your case.
Write a formal complaint letter explaining what care was denied and why you are appealing through use of the company's internal review process.
If the internal appeal is not granted through step four, file a claim with your state's insurance department.