The Direct Answer
Appeal an insurance denial as a patient by submitting a written appeal letter to your insurance company within 180 days of the denial date, along with your EOB, denial letter, and supporting medical records from your provider. Under the Affordable Care Act, patients have independent appeal rights separate from their provider. Patient-initiated appeals succeed at roughly the same 63% rate as provider appeals when submitted with complete documentation.
How It Works
Find the appeal instructions on your EOB or denial letter — most insurers include a mailing address, fax number, or portal link for patient appeals. Request your medical records from your provider's office, including visit notes, test results, and any letters of medical necessity. Write an appeal letter stating your name, policy number, claim number, the denied service, and why you believe the denial was incorrect.
Submit your appeal with all attachments through the method your insurer specifies. Keep copies of everything you send and note the date submitted. The insurer must respond within 30 days for most commercial plans. If your first-level appeal is denied, you can request an external review — an independent third party evaluates your case. Denial Appeal Pro helps patients by generating a complete appeal letter from your EOB in under 60 seconds, without requiring billing knowledge.
What You Get
A complete patient appeal letter with your claim details, denial reason restated, a targeted argument for why the denial should be reversed, and a list of records to attach. The letter uses the medical billing terminology insurers expect while remaining readable for patients who are not billing professionals.
Patient appeals matter because denied claims often become patient responsibility — a $2,000 denied MRI or a $500 denied lab panel lands on your bill. Filing an appeal costs nothing but time, and 63% of appeals succeed at first level.
Your provider may have already appealed on your behalf — but if that appeal failed or was never filed, your independent patient appeal rights under the ACA still apply.
Frequently Asked Questions
How long do patients have to appeal an insurance denial?
Most commercial plans allow 180 days from the denial date for a patient to file a first-level appeal. Medicare allows 120 days. Check your EOB or denial letter for the exact deadline and filing instructions.
What documents do I need for a patient appeal?
You need your denial letter or EOB, a written appeal letter explaining why the denial should be reversed, and supporting medical records from your provider. Request records from your doctor's office if you do not have them.
Can a patient appeal if the provider already appealed?
Yes. Patients have independent appeal rights under the Affordable Care Act. Even if your provider's appeal was denied, you can file your own patient-level appeal and request an external review.
Can Denial Appeal Pro help patients write appeal letters?
Yes. Patients can upload their denial letter or EOB and Denial Appeal Pro generates a complete appeal letter in plain language with the correct medical billing terminology — no billing expertise required.
Write Your Patient Appeal Letter in 60 Seconds
Upload your EOB or denial letter and Denial Appeal Pro generates a complete patient appeal — no billing knowledge needed.
Appeal This Denial Free →