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Health Insurance Won’t Cover Your Care?

Don't Accept That Denial

Empower yourself with step-by-step healthcare appeal letter templates created by a healthcare professional

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We’ve all been there…

You finally got an appointment with your doctor to take care of the nagging issue that’s been bothering you for months. The doctor takes the time to examine you and listen to your concerns (which sometimes seems like a rarity these days). You discuss your options and choose a treatment that’ll work best for you.

You leave the office feeling hopeful. You’ve got your prescription or a follow up appointment. You’re looking forward to feeling better and not having this health issue hanging over your head. Getting back to work or that hobby you had to give up. 

But in a week or two, the envelope arrives…

Your health insurance company has denied coverage for your treatment.

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Many people don’t realize this, but your health insurance company’s first decision is NOT the final say.

You have the ability to appeal your denied claim, but almost no one ever does. 

That’s because appealing a health insurance denial can be:

  • Confusing- what information are they looking for?
  • Time consuming- how do I figure out how to write an appeal letter?
  • Overwhelming- how do I present all this in a convincing way?

That’s where I come in…

Through my work in healthcare, I’ve seen behind the scenes of multiple insurance companies across the country. I’ve had a first hand look at:

  • The criteria they used to decide whether to approve or deny your coverage
  • The different appeals processes used by each insurance company (they’re not all the same!)
  • The differences between appeals that worked and those that didn’t

Insurance companies get a bad rap. I’m not saying they don’t deserve it, but it’s not the entire picture. 

Often, I saw people not getting the healthcare they needed simply because the insurance company wasn’t getting the information that they needed.

While I certainly can’t fix everything that’s wrong with our healthcare system, I can tell you what you need to know to appeal a denied health insurance claim. 

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That’s why I created these easy-to-follow health appeal letter templates! 

My goal is to provide you with the tools to create a customized, persuasive appeal letter that gets you coverage for the healthcare you deserve.

These templates are written in your insurance company’s language with directions on how to add in the information they’re looking for to approve the specific treatment you need.

Your insurance company’s denial shouldn’t dictate your health journey.

Let me help you increase your chances of securing coverage for the healthcare you need with a strong appeal letter. 

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Frequently Asked Questions

You can let your doctor’s office handle your appeal, but I personally don’t recommend it because:

  • Your doctor’s office often isn’t all that much more knowledgeable about what insurance companies are looking for than the general public.
  • The staff in your doctor’s office is often just as overworked and stressed as any other workplace as they handling everyone’s appointments, prior auths, and appeals all at once with minimal resources. Your appeal can’t have their full attention.
  • Your doctor’s office can only send in records of your treatments at that office. Most people, especially anyone with a chronic illness, have records at multiple doctor’s offices.

Yes!

41% of health insurance appeals resulted in the previous denial being overturned (the claim was approved).

This is according to data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals through ACA Marketplace plans, in 2021 (the most recent year we have data for).

Don’t mistake these appeal letter templates for the generic free ones you can find online. 

These templates are written in your insurance company’s language with directions on how to add in the information they’re looking for to approve the specific treatment you need.

Let’s be honest, insurance companies have armies of lawyers writing loopholes into your policy so they can keep the money you pay in premiums to themselves. So unless you have an equally matched set of lawyers, it would be impossible to guarantee the success of any appeal.

These easy-to-follow templates were created based on my extensive experience in the healthcare field. They’re written with the wording used by insurance companies and with my knowledge of what pieces of information your insurance company is looking for when they approve or deny a treatment.

I believe they’ll offer you your best chance to have your denial overturned and get the care you want.

You’ll get your chosen appeal letter template delivered as a Google Doc (no software to buy or gmail account needed). It comes with directions on how to fill in your specific medical details that the insurance company will be looking for. You also get a copy of my tips and tricks sheet for dealing with your health insurance company. 

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