After a claim is denied by a health insurance provider, what must a policyholder do to appeal?

To appeal a denied claim, a policyholder must submit a written request for reconsideration. This step is crucial because it specifically addresses the insurer's decision by formally challenging it in writing, providing the insurance company with the opportunity to review the claim again based on the additional information or clarification provided by the policyholder.

A written request for reconsideration outlines the basis for the appeal, which can include new evidence or a different interpretation of the policy terms that may support the claim. This process is often dictated by the insurer's internal guidelines and state regulations, which typically require a structured approach to appeals to ensure that they are reviewed fairly and thoroughly.

While contacting an insurance agent may facilitate guidance through the process, it does not constitute the formal appeal itself. Reapplying for coverage is unrelated to the claims process and does not rectify an already denied claim. Filing a complaint with the state might be an option if the issue escalates or remains unresolved after the appeal process, but this step comes after the initial appeal has been attempted and is not a direct method for appealing a claim denial.