Overview of the Appeal Process For Denial of Eligibility for Enrollment
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The Overview of the Appeal Process for Denial of Eligibility for Enrollment in the World Trade Center (WTC) Health Program provides applicants with a brief summary of the appeal process; timelines for the appeal process; and Frequently Asked Questions about the appeal process.
If you need help in understanding the appeal process, call:WTC Health Program Call Center
Monday through Friday
9 a.m. to 5 p.m. (Eastern Time Zone)
The Call Center will refer you to the appeal coordinator who can explain the appeal process and answer any questions you may have.
Brief Summary of Appeal Process for Denial of Eligibility for Enrollment
Any applicant denied eligibility for enrollment in the WTC Health Program has the right to appeal the denial of eligibility for enrollment.
To appeal, you must mail or fax a written letter to the WTC Health Program appeal coordinator within 60 calendar days from the date on the top of the denial letter. The appeal coordinator will notify you by letter if your appeal request is accepted or not. If your appeal request is accepted, a review of your appeal for denial of eligibility for enrollment will be scheduled promptly. If your appeal request is not accepted, you will be informed of the reasons why it was not accepted. No further consideration will be given to your appeal request by the WTC Health Program.
After the review of your appeal is complete, the appeal coordinator will send you a letter informing you of the final decision on your appeal and any actions taken by the WTC Health Program resulting from the final decision. If your appeal is denied, no further consideration will be given to your appeal request by the WTC Health Program and any further action would have to be pursued legally outside the administrative appeal process of the Program.