Follow Up Appeal(Submitted Timely) Letter Free Download


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Health Symphony Appeal Letter

Follow Up Appeal
(Submitted Timely)

Your name and address

Date

Address of Claims review department

RE: Name of Insured:
Plan ID #:
Claim #:

Dear Claims Review Department:

On [date of first letter], I appealed a denied claim for [name of insured person]. A copy of that appeal letter is enclosed. This appeal letter was sent to you within the 180 days required. However, in following up with you, I have been informed that you have not received my appeal.

I have followed your guidelines and performed the actions required to have my denial reconsidered, but since you are unable to locate my appeal, you are declining my appeal as being received past the timely limitation.

I did not mail my appeal certified or overnight, and therefore, I do not have a receipt or notice to provide you. This was not a requirement of your plan. I have confirmed the appeal address and assure you that the address I submitted it to is correct. Evidently, it appears that your mailroom has misplaced my appeal letter.

I would like for you to reconsider my appeal and to take into account the misplacing of my appeal. For this reason, I am attaching another copy of my original appeal.

I believe I have received medically necessary and appropriate care and it should be covered by my health plan.

I hope to hear from you soon.

Sincerely,

[Insured Name]

Enclosures:
A statement of medical necessity from your medical provider if requested
A copy of original appeal letter