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 7th to 15th 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.

  • Doctor’s note.
  • Medical records.

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