ProPublica’s Claim File Helper lets you customize a letter requesting the notes and documents your insurer used when deciding to deny you coverage. Get your claim file before submitting an appeal. [h/t Pete Weiss]
“What’s a Claim File? Why Should I Request One? A claim file is a collection of the information your insurer used to decide whether it would pay for your medical treatment or services. Most people in the U.S. facing a denial have the right to request their claim file from their insurer. It can include internal correspondence, recordings of phone calls, case notes, medical records and other relevant information. Information in your claim file can be critical when appealing denials. Some patients told us they received case notes showing that their insurer’s decision was the outcome of cost-cutting programs. Others have gotten denials overturned by obtaining recordings of phone calls where company staff introduced errors into their cases…”
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