MAKE YOUR FREE Letter to Appeal a Medicare Part A Denial

Create Your Document In Just 3 Easy Steps:

Build your document

Answer a few simple questions to make your document in minutes

Save now, finish later

Start now and save your progress, finish on any device

Download, print & share

Store securely, share online and make copies

OTHER NAMES Medicare Part A Denial Appeal Letter Letter to Challenge Medicare Part A Denial

What is a Letter to Appeal a Medicare Part A Denial?

A Letter to Appeal a Medicare Part A Denial helps you argue a Medicare decision that went against you. Maybe you want to know more about why you were denied or maybe you want to challenge it. A Letter to Appeal a Medicare Part A Denial helps you get clarification and request that the decision be reconsidered.

If you've been denied a claim, a Letter to Appeal a Medicare Part A Denial can help you figure out why, and possibly help you get the decision changed. There are a lot of details to keep track of with Medicare such as open enrollment periods and coverage exceptions. Don't panic if you've been denied a claim. It's possible to challenge that denial - or at least get more information so you're better prepared in the future. Medicare is a great program, but sometimes there are flaws. Your first step to challenging your denial is sending a Letter to Appeal a Medicare Part A Denial.

When to use a Letter to Appeal a Medicare Part A Denial:

You've been denied a Medicare Part A claim and want more information.
You want to challenge a Medicare Part A denial.

This document has been customized over 1.9K times

Ask a lawyer questions about your document

Re: Beneficiary's Name:

Medicare No:

The purpose of this letter is to request reconsideration of your initial decision regarding

The name and address of the health care provider and information regarding the services received are summarized below.


Health Care Provider:


Address:


	,

The date of admission or the date services began was on .

I received your initial decision on . I subsequently received notice(s) regarding this claim on:

The initial decision was made by:


Name:


Address:


	,

I do not agree with the determination of this claim. Please reconsider this claim because

You may contact me if you have any questions or need additional information. or

Thank you for your assistance in this matter.

Sincerely,

Try Rocket Lawyer FREE for 7 days

Start your Premium Membership now and get legal services you can trust at prices you can afford. You’ll get:

All the legal documents you need—customize, share, print & more

Unlimited electronic signatures with RocketSign^®

Ask a lawyer questions or have them review your document

Dispute protection on all your contracts with Document Defense^®

30-minute phone call with a lawyer about any new issue

Discounts! Incorporate for FREE + hire a lawyer with up to 40% off*

*Free incorporation for new members only and excludes state fees. Lawyer must be part of our nationwide network to receive discount.