Share Your Experience With Health Insurance Denials & Appeals
Thank you for your interest in sharing your experience with your health insurance company.

We are conducting this survey to better understand the challenges that cancer patients are experiencing with their insurance company denying coverage for their medical care. Your responses will also help us identify ways that we can better educate and support patients through the appeals process.

Your personal information will not be shared with anyone. However, if you are interested in sharing your experience with elected officials or media outlets, or are willing to share additional information with Triage Cancer, you can let us know at the end of the survey.

If you have any questions, please email info@triagecancer.org.
First Name *
Last Name *
Email address *
Phone Number *
City *
State *
Zip Code *
Type of Cancer *
Type of Health Insurance (check all that apply) *
Required
Have you ever had your health insurance company deny coverage for a particular treatment, procedure, prescription drug, etc.? *
Required
Did you file an internal appeal of the insurance company's denial of coverage? *
If you did not file an internal appeal, why? *
If you did file an internal appeal, what happened? *
If you filed an internal appeal, but the care was still denied, what happened? *
If your internal appeal was denied, did you file an external appeal? *
If you did file an external appeal, what happened? *
Is there anything else you would like us to know about your experience with the appeals process?
Are you are wiling to share details about your experience with Triage Cancer, so that we can better help other patients? We will contact you if you are interested. *
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