Appeal Letter Generator

Select Scenario

Enter Details

Get Your Letter

Select your denial scenario (click to choose):

Scenario:

Patient Name

Insurance Company

Policy / Member ID Number

Claim Number

Date of Service

Denial Date

Procedure / Treatment / Medication

Treating Physician Name

Your Name (person appealing)

Today's Date

Additional Details (diagnosis, ICD codes, previous treatments, etc.)

✅

Your appeal letter is ready!

Review the letter below, then copy or print it. Send via certified mail or your insurer's appeal portal.

Next Steps After Sending:

Send via certified mail and keep the tracking number
Note your appeal deadline: Calculate it here
If your internal appeal is denied, check external review eligibility
Insurers must respond to internal appeals within 30-60 days (15 days for urgent care)
Contact your State Insurance Commissioner if the insurer violates the timeline