Chapter Nine · dated companion
The envelope is not weather.
Ask the decision to exist. Do not let the request replace the procedure that protects your rights.
Last reviewed · September 1, 2026
This page is general information, not legal or medical advice. Coverage, deadlines and review routes differ. Read the denial notice and your plan document first. If waiting may put health at risk, involve the treating physician and use the urgent procedure immediately.
The three questions
- 1. Under what written criteria was this decision made, and may I have them?
- 2. What information about my case was reviewed, and what was its source?
- 3. Who decided — a person, a system, or a person signing for a system — and who reviews it?
A record, not a substitute for an appeal
Identify the decision and reference number. Ask the three questions in writing. Request that your letter and the response be kept in the claim file. Sign, date and keep proof of transmission.
Then follow the actual appeal instructions and deadline in the notice. A document request does not stop the clock and should not be used in place of an appeal.