TEMPLATE LIBRARY

Appeal letter templates

Pick the template that matches your denial reason. Every letter cites the specific federal regulation that gives you the right to appeal — and lists the exact evidence to attach.

Roughly 44% of denials that are appealed get overturned in the patient's favor, yet fewer than 1% of denials are ever appealed. A structured letter — citing the plan document, the CFR, and the clinical evidence — is the single biggest lever you have.
Not medically necessary
Medical necessity denial appeal letter

Denials that say the service, drug, or admission was not medically necessary.

ERISAACA MarketplaceMedicare Advantage
Prior authorization not obtained / required
Prior authorization denial appeal letter

Denials because prior auth was allegedly not obtained or was denied on medical grounds.

ERISAACA MarketplaceMedicare Advantage
Experimental or investigational
Experimental / investigational denial appeal letter

Denials labeling a treatment experimental despite FDA approval or peer-reviewed support.

ERISAACA Marketplace
Out-of-network provider
Out-of-network denial appeal letter

OON denials where care was emergent, no in-network provider was available, or a network gap exception applies.

ERISAACA Marketplace
Step therapy not completed
Step therapy override appeal letter

Denials requiring a patient to fail cheaper drugs first when that is clinically inappropriate.

ERISAACA MarketplaceMedicare Advantage
Out-of-network emergency billing
No Surprises Act — emergency billing appeal

ER visits, ambulance, or ancillary services billed OON despite No Surprises Act protections.

ERISAACA Marketplace
Mental health / substance use benefit denied more strictly than medical
Mental Health Parity denial appeal letter

Denials of therapy, residential, or SUD care with stricter limits than a comparable medical service.

ERISAACA Marketplace
Any ERISA plan denial
ERISA claim file request + appeal letter

Employer / ERISA plan denials where the reviewer's file is essential to appeal properly.

ERISA
Final internal denial (medical judgment or E/I)
External / independent review request letter

Final internal denials involving medical necessity or experimental/investigational judgments.

ERISAACA Marketplace
Urgent care needed
Urgent / expedited appeal request letter

Situations where waiting for a standard appeal could seriously jeopardize your health.

ERISAACA MarketplaceMedicare Advantage
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Not legal or medical advice. This page is a self-help resource. You make your own decisions. Strip personal identifiers (name, date of birth, address, member ID) from any document before uploading or sharing. The information here summarizes commonly-published payer policies and federal rules; confirm against your specific plan document and the current denial letter before acting.