Journalism and research ยท ProPublica
ProPublica Claim File Helper
A free tool from ProPublica that builds a letter asking your health insurer for your claim file: the notes, call recordings and records it used to deny you. Request it before you appeal.
Know before you go
ProPublica is a newsroom, not a law firm, and the tool only makes the request letter; it does not file an appeal for you. The page says a claim file request should be fulfilled within 30 days, and that some insurers do not respond or send incomplete files. The tool asks a few questions to check whether you are eligible, and sharing your details with reporters is optional. The page says what you enter is not stored without your consent.
- Cost
- Free to use. ProPublica is a donation-funded nonprofit newsroom (research report).
- Where
- Nationwide
- How to start
- Answer the questions to produce a PDF letter, then mail, fax or upload it to your insurer. The page says to send copies, not originals, and to use certified mail.
- Have ready
- Your member identification number; Your claim or case numbers; Your insurer's name and address; Your denial letter
Where this comes from
- Provider
- ProPublica
- Source we read
- https://projects.propublica.org/claimfile/
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
AppealArmor
A free web tool that reads a photo or text of your denial letter, shows you what it read, and emails an appeal letter and a Next Steps sheet with where to send it and your deadline. It also has a deadline calculator.
From AppealArmor
- Program or service
California Independent Medical Review decision search
A searchable database of every California Independent Medical Review decision since 1 January 2001. Search by drug, treatment, therapy or condition to read how reviewers decided cases like yours.
From California Department of Managed Health Care
- Program or service
Crohn's & Colitis Foundation appeal letter library
Customizable appeal letters for Crohn's disease and ulcerative colitis treatments, tests and dose changes, including a request to use a biologic without first failing other drugs. Written for the doctor's office to edit.
From Crohn's & Colitis Foundation