How to Challenge a Medical Insurance Claim Denial
Instructions
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Fill out the appeal form in detail and mail it to the insurance company. The appeal form should have been sent to you along with your denial notification. If you did not receive an appeal form, contact your medical insurance company and ask that an appeal form be mailed to you. The customer service phone number should be located on the back of your insurance identification card.
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Obtain a letter of medical necessity from your physician. The letter of medical necessity should include why it is necessary for you to receive the denied procedure and why no other procedure would be adequate. Mail this letter to your medical insurance company to support your appeal.
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Respond immediately to all correspondence initiated by the insurance company. Most people change insurance carriers an average of every two years, so it is common for insurance companies to deny a claim in hopes that they will not have to pay and you will obtain a new health insurance policy before appealing the denial.
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