Generate Your Appeal Letter

Complete each step carefully. Your letter is built from the details you provide — the more accurate your information, the stronger your appeal.

1Your Info

2Denial Type

3Denial Reason

4Rebuttal

5Review

6Generate

Your Information Step 1 of 6

Your Information

Enter your details exactly as they appear on your insurance card and denial notice.

Full Name *

Date of Birth *

Member ID *

Insurance Plan Name *

Insurer Name *

Claim Number *

Date of Service *

Date of Denial *

Your Mailing Address *

Appeals Address * (Copy exactly from your denial notice)

Your Phone (optional)

Your Email (optional)

Please complete all required fields.

What type of denial did you receive?

Select the category that best matches the reason stated in your denial notice.

📋

Prior Authorization Denied

Authorization not obtained, denied, referral missing, expired, or wrong code

🏥

Medical Necessity Denied

Treatment not medically necessary, experimental, excessive level, duration, or step therapy

📍

Out-of-Network / Provider Not Covered

Provider not in network, no alternative, emergency OON, referral OON, or directory error

📂

Administrative Denial

Late filing, missing documentation, duplicate claim, eligibility, or billing code

📊

Benefit Limit Reached

Annual visit limit, inpatient day limit, dollar cap, misclassification, or plan year carryover

Please select a denial category.

What is the specific denial reason?

Select the reason that most closely matches the language in your denial notice.

Specific Denial Reason *

Please select your specific denial reason.

Choose your rebuttal approach

Select the argument that best fits your situation. This becomes the core of your appeal letter. Read each option carefully before selecting.

Please select a rebuttal approach.

Review Your Selections

Confirm the details below before generating your letter. Go back to make changes if needed.

Your letter is ready to unlock

Review the preview below then complete payment to download your full professional appeal letter.

^$14.99

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✓ Payment confirmed. Your appeal letter has been generated. Review it below, make any final edits, then download as PDF.

📎 Before you submit: Attach any relevant documents your denial notice identifies as supporting your case — this may include a letter of medical necessity from your treating physician, relevant medical records or clinical notes, or prior authorization correspondence. Keep copies of everything you submit and retain proof of submission.