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  A1 Letters  





Write an appeal letter for services denied as "Not Medically Necessary".

Dear Customer Service Department:


I am writing to appeal [name of medical group OR health plan]'s decision to deny authorization for [name of service, procedure/ treatment sought] for me. The [medical group OR health plan] has denied coverage for [name of service, procedure/ treatment], as not medically necessary. I believe [name of service, procedure/ treatment sought] is medically necessary to [treat or diagnose/ address] my medical condition and is covered by my health plan. [Name of medical group/health plan] should approve [name of service, procedure/treatment] in my case.

I would like to inform you that failure to provide immediate treatment for my condition involves an imminent and serious threat to my health. I am, therfore, requesting an expedited review of my appeal. Kindly notify me of your decision at the soonest possible.

I am enclosing documentation of my medical condition, and information supporting the medical necessity of [name of service/procedure], with this letter. Please let me know if any additional information will be helpful to my request. I can be reached at [telephone number].

I shall appreciate your immediate attention to this matter.





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