- 1). Obtain a copy of your insurance plan description documents. If you have your medical insurance through your job, a copy of this document should have been provided to you when you accepted your job. If your spouse's job provides medical insurance for you, ask your spouse for the information. If you purchase your own private medical insurance, these documents should have been provided upon purchasing the plan. If you do not have the documents in your possession, ask your employer (or the provider if you bought your own plan) to provide you with a copy.
- 2). Review the plan documents carefully. Look for a section that states "Appeals" and "How to File an Appeal." In addition, look for the timing of when to file the appeal. You want to look for the way to go about filing the appeal; many insurance companies provide the exact manner in which the appeal must be filed and a failure to file the appeal in the precise way will automatically result in a loss of the appeal. Once located, highlight this section.
- 3). Draft a letter of appeal. In your letter of appeal, be sure to include the reason why you are appealing the denied medical referral. Clearly cite any medical reasons for the medical referral and include medical documentation, such as test results or a letter from your doctor indicating the reasons why you need to obtain the medical referral.
- 4). Follow the "Appeal" process exactly as described in the plan description and include your letter of appeal. Mail the appeal to the address provided in the plan description by certified mail with a return receipt requested so you have proof that the appeal was received by the insurance company. If you do not get a response within a reasonable timel, be sure to follow up with the insurance company to know the status of the appeal.
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