Hardship Letter Examples

   Timely Filing Appeal Error

{Your Name}
{Your Address}
{Your Phone #}


Dear {Name}:

On {date}, I received a notice from your office informing me that the medical claim for patient {ID No.} totaling {amount} has been denied. I would like to contest the grounds that we failed to file the claim in a timely manner, and I respectfully request that you reconsider the claim.

Your policy states that claims must be filed after {number} days. This claim was submitted {date}, after only {number} days. I understand that there was a clerical error after the initial submission, and that the patient's last name had been misspelled. I apologize for the mistake. However, we quickly rectified the error and resubmitted the claim on {date}. At that point, the timely filing requisite caused a rejection of the claim.

All efforts were made in good faith to submit the claim before the deadline. I have attached copies of the original submission (date and time stamped) and highlighted the error that created the necessary resubmission. Please contact me at your earliest convenience to update our office on the current status of this claim.

Thank you,

{Sender Name}

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