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New Jersey Department of Banking and Insurance Independent Health Care Appeals ProgramEXTERNAL APPEAL APPLICATION MEDICAIDReturn Application by mail to: Email application to:New Jersey Department
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External appeal application is a formal request made to an independent third party to review a decision made by a health insurance company regarding coverage of a medical treatment or service.
Any individual whose health insurance claim has been denied and who wishes to challenge the decision is required to file an external appeal application.
To fill out an external appeal application, the individual must provide personal information, insurance details, reasons for appealing the decision, and any supporting documentation.
The purpose of an external appeal application is to seek an impartial review of a health insurance company's decision to deny coverage for a specific medical treatment or service.
Information such as personal details, insurance policy number, reasons for appeal, medical records, and any supporting documents must be reported on an external appeal application.
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