Insurance Denied Again? Here’s What to Do Right Now

Sarah Brumley

Sarah Brumley

You followed the process, got the referral, showed up for the appointment—and then the insurance denial lands in your inbox. We’ve been there. In Part 2 of this series, I’m walking you through exactly what to do when insurance says no—from appeal letters to staying organized, and everything in between. Feeling overwhelmed by the fight? You don’t have to do it alone. Let’s get started.

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Insurance Denied Again? Here’s What to Do Right Now

Hey friend, and welcome back to the Financial Fix Up Podcast. I’m your host, Sarah Brumley, and today we’re continuing our conversation about something that hits way too close to home for so many of us: medical costs and the insurance battles that come with them.

Last week in Part 1, we talked about how to plan ahead before a crisis—and what to do when the bill lands and you don’t have the money to pay it. And honestly? That’s hard enough on its own.

But today, we’re tackling the moment that can feel like a gut punch: you did everything right… and your insurance still says no.

Whether you’re holding a denial letter in your hand right now or you’ve walked this road before, I want to say this:

You’re not alone. And no—you don’t have to accept that “no” at face value.

In this episode, I’ll share what we’ve learned about the appeals process—how to stay organized, how to advocate for your family, and how to keep going even when the system feels stacked against you.

It’s not easy—but it is possible. And you are absolutely capable of doing this.

Let’s dive in.

Step #3: When Insurance Denies a Claim—And How to Appeal

Now let’s talk about what happens when you do everything right—you follow the process, get the referral, schedule the appointment—and your insurance still says no.

That dreaded denial letter shows up in the mail or your portal. “This service is not medically necessary.” Or worse, “Not covered under your plan.” And you just sit there staring at it, thinking, Seriously? After everything we’ve been through?

We’ve been there. We are currently there. And I can tell you from firsthand experience—it’s frustrating, exhausting, and completely disheartening.

Right now, we’re in the middle of appealing a denial for our daughter’s continued stay at her residential treatment facility. Her care team says it’s medically necessary. Her progress depends on it. But the insurance company decided it wasn’t worth covering anymore.

It’s not just frustrating—it’s heartbreaking. Because this isn’t just paperwork. It’s her future. Her stability. Her healing.

So when I say I understand what it feels like to be overwhelmed by this process, I mean it. We’re walking it, too. And while I can’t promise the system will make it easy, I can promise you this: you can do this. You can fight for your family, one phone call, one form, and one appeal at a time.

And here’s something I didn’t know at first, and I hope it encourages you:

Insurance companies expect you to appeal.

They design the system with appeals in mind. That letter is not the end of the story—it’s the beginning of the next step.

So if you’re facing a denial right now, here’s what we’ve learned to do:

1. Start with the denial letter.

When you get that denial, don’t just toss it in a pile or close the portal tab. Open it up and read it slowly. The letter should include two key things:

  • The reason your claim was denied (look for phrases like “not medically necessary,” “not a covered benefit,” or “out-of-network”)
  • Instructions for how to file an appeal, including where to send it, what documentation is required, and how many days you have to respond.

Every insurance plan has a deadline—usually 30 to 60 days from the date of the letter. And yes, weekends and holidays count. So don’t wait. Mark the deadline on your calendar, set a reminder on your phone, and give yourself time to pull everything together.

If anything in the letter is confusing, call your insurance company and ask them to explain it. You have a right to understand what’s going on—and the clearer you are, the stronger your appeal will be.

2. Gather your documentation.

This is where your paper trail really matters. The more organized you are up front, the better off you’ll be—especially if the appeal takes time or the insurance company comes back asking for more information later on.

Here’s what to pull together:

  • Provider notes from the doctor or specialist who recommended the service or treatment
  • Referral forms or authorizations (if required by your plan)
  • Letters of medical necessity, ideally written by your provider and clearly explaining why the care was needed and/or what could happen if it’s denied
  • Lab results, imaging reports, or test results that support the diagnosis or need for treatment
  • A copy of the denial letter (you’ll want to reference this in your appeal)
  • And optionally, a short personal statement if you feel it would help paint a fuller picture

If you’re not sure what to ask your provider for, start by saying:

“I need to appeal an insurance denial. Could I get your notes from that visit, and anything that explains why the service was medically necessary?”

Once you have your documents, keep them in one place—you could choose to use a physical folder, however, I truly recommend using a computer file or Dropbox folder and digitizing everything. We’ve learned (the hard way) that appeals can take weeks or even months, and being able to quickly resend or reference paperwork can save so much time and stress down the road.

Ultimately, the more clearly you can demonstrate that this care was necessary, appropriate, and recommended by a licensed provider, the stronger your appeal will be.

And if you’re someone who usually tosses paperwork or doesn’t feel naturally organized—this is the moment to slow down and get a system in place, even if it’s just one dedicated folder on your desk.

Future you will thank you.

3. Write a clear, simple appeal letter.

This part doesn’t have to be complicated—but it does need to be clear.

In your letter, make sure to include:

  • Your full name
  • Your insurance ID number
  • The date of service
  • And a brief explanation of why you believe the denial should be overturned

You don’t need to write a novel. In fact, it’s better if you don’t. Stick to the facts. Be polite, firm, and direct. You’re not ranting—you’re advocating.

You might say something like:

“This procedure was ordered by my provider due to [condition]. It was medically necessary and aligned with standard treatment protocols. I’m requesting that this denial be reconsidered and the claim be approved.”

That’s it. Keep it short. Keep it respectful. And show that you’re paying attention. A well-worded, well-organized appeal shows them you’re serious—and that you’re not going away quietly.

4. Follow up by phone.

Once your appeal is submitted, don’t just wait in silence. Call your insurance company, confirm they’ve received the documents, and ask when you can expect a response. Get the name of the person you talk to and jot it down.

I know—it’s another phone call in a sea of phone calls. But this one matters. It keeps your case moving.

5. Keep records of everything.

I can’t emphasize this enough: document everything.

Every phone call. Every email. Every letter. Even the “I’ll check and call you back” conversations. Write it down.

Create a simple system—whatever works for you. A paper folder. A digital file on your desktop. A notebook with sticky tabs. The goal is to have all your info in one place, so you’re not scrambling when someone asks, “Who did you talk to last time?”

Here’s what to track:

  • The date of the interaction
  • The name and department of the person you spoke with
  • Confirmation numbers or case IDs
  • A quick note on what was discussed or promised

We’ve had situations where we had to reference a conversation from three weeks ago—and because we’d written it down, we could hold the insurance company accountable.

You don’t need to be fancy. You just need to be consistent.

The more organized you are now, the more power you’ll have if things need to be escalated later on.

And trust me—future you will be grateful for every single note.

Bonus Tip: Ask your provider to help.

Not every provider will be able—or willing—to help with the appeals process. But some will, and it’s worth asking.

Many hospitals and larger clinics have billing advocates or patient care coordinators who are familiar with the appeals process and can offer supporting documentation—or even help submit the appeal on your behalf. We’ve had providers go to bat for us, writing letters of medical necessity or explaining why a treatment was critical.

But we’ve also had providers who said, “That’s between you and your insurance.” So go in knowing that it varies. Ask kindly, explain your situation, and see what kind of support they’re able to offer.

Because sometimes, just one extra letter or phone call from the provider can make all the difference.

Insurance Denied Again? What Will You Do Next?

Friend, I know this is a lot. Dealing with insurance appeals, paperwork, and endless phone calls can feel like a second job—one you never signed up for. But I want you to hear me clearly:

You are not helpless in this process.

You are smart. You are capable. And you are doing exactly what a strong, loving advocate does—showing up for your family even when it’s hard.

You don’t need to have a law degree or know all the right words.

You just need to take it one step at a time. Be persistent. Stay organized. And don’t be afraid to ask for help.

If this episode helped you, I’d be so grateful if you’d share it with a friend who might be walking through a similar battle. And if you want more practical tools for navigating hard financial seasons with confidence, head over to lemonblessings.com and grab my free budgeting templates and guides.

Above all—please know that I’m cheering you on. You’ve got this. Have an amazing day, and I’ll chat with you again next time.

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