Keep the denial notice, every document you submit or receive, proof of submission, and a dated log of calls and correspondence. Preserve originals and usually send copies. Use the denial notice and your plan documents to confirm the applicable steps and deadlines: health-plan appeal rules differ, so a deadline found in a general guide may not apply to your coverage.
Records to collect for an appeal
Build one file for the disputed service or claim. Keep the complete record—not just the page that states the decision—so you can see what the insurer decided, why, and what it told you to do next.
From the insurer and provider
- The Explanation of Benefits (EOB) and any letter or notice showing the denied service or payment.
- The complete denial notice, including the stated reason, appeal instructions, contact details, and deadline.
- Relevant bills and provider records.
- Medical information supporting the appeal, such as a clinician’s letter where applicable.
- All related letters, emails, and other records you receive from the insurer or provider.
HealthCare.gov’s internal appeals guidance describes the records to keep and advises: “Keep your original documents and submit copies to your insurance company.” Follow the notice if it specifically requires an original.
Copies of everything you submit
- Your appeal form or letter, plus proof of submission or delivery if available.
- Every attachment and supporting document sent with the appeal, including later supplements.
- A signed authorization or form if a doctor or another representative is acting for you, and copies of the documents filed on your behalf.
- The insurer’s responses and final internal appeal decision.
If you seek external review, also keep the external-review request, all submitted materials, proof of submission, and the reviewer’s final decision. Use the denial or final decision to identify the specific review channel and due date; HealthCare.gov’s external review guidance describes its process.
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How to log calls and correspondence
Make a dated entry for each relevant call while the details are fresh. Record:
- Date and time.
- The representative’s name and title.
- Phone number or department, if known.
- A concise account of what was discussed, any commitments made, and the next steps or dates stated.
Keep emails and letters with the log. The CMS tracking sheet for appealing a denial can provide a checklist for calls, documents, and decisions. It was published in 2012, so use it to organize records—not as an authority for current deadlines.
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Keep originals safe and organize the file
- Keep original documents in a safe place; send copies unless the appeal instructions specifically require an original.
- Put the notice, bills, medical support, appeal submissions, delivery records, call notes, and decisions together. Arrange them by date if practical.
- Where safe and feasible, retain a duplicate digital copy as well as your paper records.
A folder or expanding file organizer is optional; buying one is not necessary to appeal. The official guidance supports keeping records but does not set a universal period for retaining the complete file after an appeal ends.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Verify the process and deadline for your plan
The denial notice and plan documents are the starting point for identifying the procedure that applies to you. Do not assume a deadline from a general article covers every plan or program.
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Internal appeal and external review
An internal appeal asks the plan or insurer to reconsider its decision. External review, when available for an eligible denial, sends the decision to an independent reviewer. Keep the request, supporting evidence, proof of submission, communications, and resulting decision at each stage.
For many plans covered by the federal consumer appeal rules, HealthCare.gov says an internal appeal generally must be filed within 180 days after receiving the denial notice. Its guidance describes decision timeframes that vary by service and urgency. For the external-review process it describes, HealthCare.gov gives a general four-month period. These are not universal deadlines or guarantees for every plan or program. Check the notice, plan documents, and applicable state or program instructions; urgent care may have an expedited procedure.
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Coverage type can change the route
Employer or self-funded coverage, individual or Marketplace coverage, and Medicare or Medicaid may have different applicable procedures. Some employer plans may include another internal appeal level. NAIC notes that Medicare and Medicaid use distinct appeal rules; consult the relevant program for its process. CMS also notes that grandfathered plans may not follow the same rules.
For help identifying a route, CMS lists state Consumer Assistance Programs where available. The NAIC consumer guidance on appealing a denied claim points consumers to the state insurance regulator for external-review information and to separate Medicare or Medicaid resources.
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