appeal a claim

Get an insurance appeal letter

Did your insurance company deny coverage for Cologuard? We can help you customize an appeal letter.

All you have to do is answer a few questions to create a customized appeal letter PDF to download 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.

Yes No

You should not have received a bill, please call Exact Sciences at 1-844-870-8870.

Did your insurer charge you co-insurance, deductible, or a co-pay for your Cologuard test?

Yes No

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.

Yes No I don't know

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

Insurance company details

Where do I find this information?

*All fields are required.

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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