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.
Denials that say the service, drug, or admission was not medically necessary.
Denials because prior auth was allegedly not obtained or was denied on medical grounds.
Denials labeling a treatment experimental despite FDA approval or peer-reviewed support.
OON denials where care was emergent, no in-network provider was available, or a network gap exception applies.
Denials requiring a patient to fail cheaper drugs first when that is clinically inappropriate.
ER visits, ambulance, or ancillary services billed OON despite No Surprises Act protections.
Denials of therapy, residential, or SUD care with stricter limits than a comparable medical service.
Employer / ERISA plan denials where the reviewer's file is essential to appeal properly.
Final internal denials involving medical necessity or experimental/investigational judgments.
Situations where waiting for a standard appeal could seriously jeopardize your health.
Upload your denial letter. We'll pick the right template, cite the right statute, and pre-fill your clinical facts.