Medical Appeal Letter Templates

Professional letter templates for insurance appeals, billing disputes, and financial assistance applications. These templates use proper legal language and include all necessary elements to improve your chances of approval. All templates are free to use and can be customized for your specific situation.

Why These Templates Are Effective

✓ Professional Legal Language

Written with terminology that insurance companies and providers respect

✓ Evidence-Based Requests

Demands specific documentation and criteria for stronger appeals

✓ Regulatory Compliance

References relevant laws and regulations that support your case

✓ Clear Next Steps

Includes escalation paths and follow-up procedures

Available Templates

Appeal "Not Medically Necessary" Denial

Challenge insurance denials claiming treatment was not medically necessary

Insurance AppealsHigh Priority

60-180 days to appeal

Use Template
Professional legal language for stronger appeals
Requests specific denial criteria and documentation
Emphasizes physician expertise and patient safety
Template for follow-up external review requests

Prior Authorization Appeal

Appeal denied prior authorization requests for treatments and procedures

Insurance AppealsHigh PriorityComing Soon

30-60 days to appeal

Coming Soon
Emphasizes medical urgency and necessity
Requests expedited review when appropriate
Includes peer-to-peer review requests

Hospital Charity Care Application

Apply for financial assistance and charity care programs

Financial AssistanceMedium PriorityComing Soon

Apply within 240-365 days

Coming Soon
Emphasizes financial hardship documentation
Requests payment plans and sliding scale options
Includes asset protection language

Medical Bill Dispute Letter

Dispute incorrect charges, billing errors, and overcharges

Billing DisputesMedium PriorityComing Soon

Dispute within 60-90 days

Coming Soon
Requests itemized bills and charge explanations
Challenges coding errors and duplicate charges
Demands compliance with price transparency rules

How to Use These Templates

1

Choose Your Template

Select the template that matches your situation: insurance denial, billing error, or financial assistance need.

2

Fill in Your Details

Customize the template with your specific information, case details, and supporting documentation.

3

Send & Follow Up

Submit your letter via certified mail and follow up according to the template's timeline guidance.

Best Practices for Medical Appeals

Before You Write:

  • • Gather all relevant medical records, bills, and correspondence
  • • Check your insurance policy or hospital's financial assistance policy
  • • Note all deadlines - most appeals have strict time limits
  • • Get a copy of the denial letter or billing statement in question

When Writing Your Letter:

  • • Be specific about what you're appealing and what you want
  • • Include all relevant dates, claim numbers, and reference numbers
  • • Attach copies (not originals) of supporting documents
  • • Keep the tone professional but firm

After Sending:

  • • Send via certified mail with return receipt requested
  • • Keep copies of everything you send
  • • Follow up if you don't hear back within the stated timeframe
  • • Document all phone calls and correspondence

Need a Different Template?

We're continuously adding more letter templates for different situations. In the meantime, these resources can help with most medical billing and insurance issues:

Disclaimer: These templates are for educational purposes only and do not constitute legal advice. While these templates follow best practices, every situation is different. For complex cases or significant amounts, consider consulting with a qualified attorney or patient advocate. CareRoute is not responsible for outcomes from using these templates.