HMO Giving You a Hard Time? Write an Effective Appeal Letter
In 2009, according to a press release by the Nurses Association of California, the six largest HMOs in that state had declined nearly 31 million claims, or just over 20% of all that they received. That number might seem a bit absurd, but it means that it can be tough for you to get the coverage you need when a medical condition arises, even if you have health insurance. What is more troubling, is the fact that information about why claims have been denied in the past is hard to find, making it difficult for you to appeal the decision if you have been denied. However, if you wish to make an appeal, you can learn how to write insurance appeal letters and try to prove that you deserve coverage for medical treatments or procedures.
While trends and stats vary from state to state, in Oklahoma, nearly a third of people who present an appeal are able to overturn the initial decision. But because so many people fail to get the decision reversed, you should make sure to take time figuring out how to write insurance appeal letters and doing the proper research. Checking out some previous appeals cases similar to yours can help you establish an argument and present a persuasive case. This is a must if you want to make sure that you are able to make the appeal process a successful one.
Since writing insurance appeals letters is not always easy, especially for individuals who have no experience doing so, then using helpful resources is a must. Fortunately, the internet is loaded with thousands of insurance denial appeal letter templates that can help you determine out exactly what you should say, and how you should say it. They are one of the most helpful tools available because they provide definitive examples of what a health insurance denial appeal letter should look like.
There are certain things that should always be included in appeal letters. They must have information about why you think the original decision was incorrect, evidence to support that decision, and a time period where you expect to hear back from the recipient. If you do not give a specific time, insurance companies could take a long time reviewing your case, and possibly forget about you altogether. So including that with the other information is a must when it comes to writing a proper appeal letter.