DATE: ____
Corrine R. Paiva
5330 Desert Peach Drive,
Sparks NV 89436
Corrine85@charter.net
Claim No. 2020128CB4779
Doctor’s Name: __
Anthem Insurance Companies
3075 Vandercar Way
Cincinnati OH 45209
Dear Sir/Madam,
RE: INSURANCE CLAIM APPEAL.
My name is Corrine R. Paiva, Claim No. 2020128CB4779. I am appealing the insurance charges
971.30 USD made during the period from 7 th to 15 th April 2020. The aim of this appeal is to
change the insurance cover to include routine service since I have my blood drawn every six
months and an iron infusion every year. This is due to the fact that these services are routine
services and checkups since I am anemic (see attached the doctor’s note and medical records).
I had chosen a different cover that is now not including the service I hereby seek. I’d appreciate
the change since a biannual blood check and an annual iron infusion only qualify as routine
checkup as opposed to it being a as I’m being charged for.
Kindly review the doctor’s note and the medical reports attached and reconsider the disputed
insurance charges mentioned. Take consideration the medical reports attached in order to make
the necessary changes sort. I shall be available should you need any additional information or
documentations.
Your prompt consideration of this appeal letter shall be appreciated.
Respectfully,
Corrine R. Paiva.
Enclosed.
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