How to appeal the decision. How to request a written statement giving the medical reason for the denial. In an emergency situation you can go to a non-plan emergency room if going to a plan facility would delay treatment and worsen the emergency. Your health plan must pay for services-vices necessary to evaluate and stabilize you, even if the screening finds no emergency actually existed, if a reasonable person would have believed there was an emergency. All health plans must have written procedures for dealing with appeals.
Most plans require that the request be in writing.
The plan's letter telling you of the appeal decision must be sent to you within 20 days of the appeal request. The reviewer's statement of the reason for the appeal. The medical reason for the decision. How to file a second level appeal. Most large corporations and businesses offer some plans that are self-insured.