Download "Follow Up Appeal Letter" Word Document
Appeal Letter Displayed for Your Convenience
Health Symphony Appeal Letter
Follow Up Appeal
Your name and address
Address of Claims review department
RE: Name of Insured:
Plan ID #:
Dear Claims Review Department:
On [date of first letter], I appealed a denied claim for [name of insured person]. A copy of that claim and appeal letter is enclosed.
I would like to take this opportunity to follow up with you on my original appeal. As of yet, I have not heard from you [or the claim remains denied; or give other reason here]. For this reason, I am attaching another copy of my original appeal.
If I do not hear from you promptly, I will have no alternative but to seek other options. 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.
A statement of medical necessity from your medical provider if requested
A copy of original appeal letter