Appeal Letters

Download Customizable Appeal Letters for Your Patients

Support Your Patients with Tailored Appeal Letters

As a healthcare provider, you understand the complexities of managing inflammatory bowel diseases (IBD) and the unique challenges your patients face. To assist in advocating for their needs, we offer a collection of customizable appeal letters to help patients access essential treatments, accommodations, and resources.

These letters are available in Microsoft Word format, making it easy for you to personalize them for each patient’s specific situation.

Have suggestions for additional appeal letters? Contact the IBD Help Center at [email protected]. Our committee periodically reviews requests to expand our resources.

Appeal Letters for Medication Coverage & Testing

Ensure your patients receive the diagnostic testing and medication monitoring they need.

• General TDM Appeal Letter
• Adalimumab Drug Level Testing
• Infliximab Drug Level Testing
• Metabolite Level Testing
• TPMT (Thiopurine Methyltransferase)
• Ustekinumab Drug Level Testing
• Vedolizumab Drug Level Testing

Accommodations & Disability Support

Help your patients obtain necessary accommodations for school, work, and daily life.

• School Accommodations
• Employment Accommodation
• Private Dorm and Bathroom
• Social Security Disability

Financial & Mental Health Resources

Support your patients with access to life insurance, financial aid, and mental health services.

• Life Insurance
• Financial Resources
• Mental Health Benefits
• NASPGHAN - Advocacy Letters for Children with IBD
• Ostomy Patient Assistance

Medication Dose Escalation Requests

Help ensure appropriate medication adjustments for optimal patient outcomes.

• Adalimumab
• Certolizumab
• Infliximab
• Tofacitinib
• Ustekinumab
• Vedolizumab

Prior Authorization Assistance

Advocate for necessary treatments and overcome insurance barriers.

• Request for Biologic Management of Crohn's disease Without Meeting Fail First Requirement
• Request for New Medication for TNF Nonresponder
• Request for Off-Labeling
• Vedolizumab for Ulcerative Colitis
• Visbiome for Pouchitis
• Herpes Zoster vaccine

Tests/Procedures Coverage Requests

Ensure patients receive crucial diagnostic and monitoring procedures.

• Calprotectin
• Capsule Endoscopy

Download and customize these letters today to support your patients in accessing the care they need. If you have any questions or additional letter requests, reach out to the IBD Help Center at [email protected].

This content was developed by Professional Members of the Crohn's & Colitis Foundation.

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