Appealing a Denied Test or Scan

You have 180 days from the date on the denial letter to file an internal appeal — mark that date the day it arrives. Standard internal appeals must be decided within 30 days; if waiting that long could seriously harm you, you can request an expedited appeal, which must be decided within 72 hours. If the internal appeal still says no, you have the right to an external review — a genuinely independent organization, not affiliated with your insurer, whose decision is binding on them. You typically have about four months after the final internal denial to request it, and standard external reviews are decided within 45 days (72 hours if urgent). This is worth doing. A meaningful share of appeals succeed, especially ones grounded in a clear, written medical necessity letter from your doctor addressing the specific reason for denial — not a general 'I need this' but a direct response to what the denial letter actually said.