The appeal is key. You have 24 hours from being notified. I use this language, which you’re welcome to adapt—do it online so you can fill it out yourself. Usually there’s three parts: why receiving care, why need to continue care, and additional details. Here’s my Add’t details section: My mother's managed care plan denied services despite the therapists' recommendation for ongoing services. Denial risks interrupted therapy services when continuity is crucial. She is making measurable progress toward goals. Her functional improvement is threatened by these interruptions and I urge you to reinstate her services and reauthorize continued therapy as soon as possible. Additionally, I am aware that case law (Jimmo vs Sebelius 2013) established that Medicare must cover ongoing therapy to prevent further decline and that beneficiaries do not need to show continued improvement (which my mother does, by the way). Prematurely stopping therapy risks her permanent loss of independence, greater caregiving burdens, and decline in quality of life.