Medical ER Authorization

{Your Name}
{Your Address}
{Your Phone #}

{Date}

Dear {Insurance Representative}:

I am writing to request reconsideration for a claim denial that was filed by {Provider} on {date} for {Patient}. The claim number is {number} and the total amount was {amount}. On {date}, {insurance plan} denied any coverage for Emergency Room admittance on the basis that it was not authorized by my health plan first. I would like to ask you to reconsider this claim.

Upon my admittance to the hospital for {reason/procedure}, I checked in with the staff and provided my insurance provider and policy number. During the procedure, my condition became unstable and I was admitted to the ER unexpectedly as a result of {event}. It was an emergency situation and I was not in a mental state to request authorization before I was admitted. As I did my due diligence by providing the insurance information to the staff, they are the ones who should be held responsible for contacting you, and I should not be penalized for actions taken during an emergency. Furthermore, I do not believe there was time to wait for authorization, as my admittance to the ER was medically justified and required immediate action.

I have enclosed a letter from my medical provider outlining the actions taken on the aforementioned date, and the reasons authorization was not sought immediately. Thank you for your time and consideration.

Thank you,

{Sender Name}

Index of Hardship Letter Examples