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Keep the denial notice, every appeal form and supporting document, proof of submission, insurer and provider correspondence, and a dated log of calls. Save originals for your files and usually send copies. The denial notice and your plan documents—not a general article—are the place to verify the deadline and exact appeal procedure.
What records should you keep?
Build one file for the disputed service or claim. Preserve the records that show what was denied, why the plan says it was denied, what you asked it to reconsider, what evidence you supplied, and what the plan decided.
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- Denial and claim records: Keep the Explanation of Benefits (EOB), denial letter, or other notice identifying the service or payment at issue. Save the complete denial notice, including the stated reason, appeal instructions, contact details, and deadline.
- Provider records: Keep relevant bills, correspondence, and medical information that supports the appeal. If applicable, include a clinician’s letter.
- Everything you submit: Keep a copy of the internal appeal form or letter, every attachment, and any later supplemental submission. Keep proof of submission or delivery when available.
- Everything you receive: Save the insurer’s written responses, any final internal appeal decision, and relevant materials from your provider.
- Representative authorization: If a doctor or another person files or communicates for you, keep the signed authorization or form and copies of the documents filed on your behalf.
- External review records: If you request external review, keep the request, supporting materials, proof of submission, and the reviewer’s final decision.
How to keep a useful communication log
Make a dated note for each relevant call while the details are fresh. Record:
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- The representative’s name and title, plus the phone number or department if known.
- A concise account of what was discussed, any commitments made, and the next steps or dates the representative gave you.
Save emails and letters as well. CMS’s Tracking Sheet: Appealing a Denial of Service includes places to track appeal requests, documents, calls, correspondence, and decisions. It was published in 2012, so use it as a recordkeeping checklist—not as authority for current deadlines.
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How to preserve and send documents
Keep originals in a safe place and send copies unless the appeal instructions specifically require an original. HealthCare.gov states: “Keep your original documents and submit copies to your insurance company.” You can organize the file in date order and retain a duplicate digital copy if it is safe and practical. A paper folder or expanding organizer is optional; buying one is not a requirement.
The official guidance supports keeping appeal records, but it does not establish one universal period for retaining the complete file after an appeal ends. No general retention period should be assumed from this checklist.
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Check the deadline and process for your plan
Appeals have stages, and the applicable route depends on your coverage and circumstances. For many plans covered by the federal consumer appeal rules, HealthCare.gov describes an internal appeal, in which the plan reconsiders its decision, and an external review, in which an independent reviewer evaluates eligible denials. The same recordkeeping habit applies at each stage: keep the request, evidence, proof of submission, communications, and decision.
HealthCare.gov’s guidance describes a general 180-day period to file an internal appeal after receiving a denial notice and a general four-month period for requesting external review in the process it describes. Those timeframes are not universal guarantees for every plan or program. Internal decision timeframes can vary with the service and urgency, and urgent care may have expedited procedures.
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Read the denial notice, any final determination, and your plan documents for the actual deadline, submission channel, eligibility rules, and any further internal level. Do not rely on a generic deadline when the governing notice or program instructions may differ.
- Employer or self-funded and individual or Marketplace coverage: Applicable appeal procedures can differ; follow the instructions for your plan and check whether another internal appeal level applies.
- Medicare or Medicaid: These programs have distinct appeal paths. Use the program-specific instructions rather than assuming the general commercial-plan process applies.
- Grandfathered plans and state rules: CMS notes that grandfathered plans may not follow the same rules. State requirements and assistance options may also affect the route.
Where to get help with the route
For plan-specific questions, start with the contact details and instructions in the denial notice and plan documents. HealthCare.gov and CMS point consumers to state Consumer Assistance Programs where available. For external-review information, the NAIC advises contacting the relevant state insurance regulator; it also directs people with Medicare or Medicaid to program-specific sources, including Medicare or the state Medicaid agency.
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