Medical Investigational Experimental Procedure

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

{Date}

Dear {Insurance Representative}:

I am writing with regards to a claim filed by {Provider} on {date} for {Patient}. The claim number is {number} and the total amount billed was {amount}. I have been informed that my claim was rejected due to the procedure being considered "investigational or experimental," and I would ask you to reconsider this rejection.

To the best of my knowledge, I have {condition}. However, after being to {number} doctors at {number} facilities in {states}, I have still been unable to receive a satisfactory diagnosis that takes into account {list of unusual/unexplained symptoms}. As such, I have taken to seeking out alternative theories, fields, and procedures.

I understand that {procedure} is considered experimental, but in this case it was completely medically necessary. Before the procedure, I suffered from {debilitating symptoms} that affected my {work, health, concentration, etc.}. The procedure revealed {new information} that led to {treatment} that has resulted in {positive result}.

Enclosed is a statement from my physician outlining the urgent and unusual nature of my condition, along with the difficulty I had achieving a satisfactory diagnosis. It is clear that this procedure was necessary and medically justified, and I appreciate you taking the time to reconsider the matter.

Sincerely,

{Sender Name}

Index of Hardship Letter Examples