Get An Insurance Appeal Letter

Did your insurance company deny coverage for Cologuard? Answer 1-4 questions to help us understand the best appeal strategy for you, and then fill in your personal information to complete a customized appeal letter you can download (PDF) and send to your insurance company.

IMPORTANT: Please be sure to read the directions carefully after your file is generated. You may be required to submit additional documents.

Are you part of a Medicare Advantage health plan? What does this mean?

A Medicare Advantage plan, also called Medicare Part C, is a Medicare plan sold by a private insurance company.

What state do you live in?

Is your health plan self-insured? What does this mean?

If your employer pays claims instead of an insurance company, your plan is self-insured. Contact the employee benefits administrator in your employer’s human resources department to find out.

What reason did your insurance company give for denying your claim?

Insurance Company Details

*All fields are required. Where do I find this information?

Insurance Company Name

Insurance Company Address

Insurance Company State

Insurance Company City

Insurance Company Zip

Patient Details

*All fields are required

First Name

Last Name

Member ID

Date Of Service (mm/dd/yyyy)

Address

City

State

Zip

Phone

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