Overcoming Anxiety in Dealing with Health Insurance Claim Appeals

Part 1: The Basic Tools, Chapter 3: Developing a Systematic Approach to Dealing with Health Insurance Page 15

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Your claim appeal form should include your insurance company identification number, prominently displayed near the top of the form. It should also include the name of the policyholder (the insured) -- if different than the patient -- the name of the patient, and the patient's address and telephone number. There should also be spaces labeled, "Provider," "Date of Service," and so on, where you can fill in the appropriate information (See Table 10).

Include several lines at the bottom, as well, labeled "Please Note." In that section, you can describe the problem you're experiencing from your point of view. For example, if the claim was rejected by error on the grounds that it was a duplicate of an earlier claim, you can briefly explain the differences between the two claims.

It's important to keep your explanation brief, clear, and unemotional, even though you may be upset with the situation. The clearer and simpler the explanation, the more likely that your request will be clearly understood and that the error will be corrected quickly. If you're not certain what to write in the "Please Note" section, you can print a general statement such as, "Please review this claim."

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