Treatment denied? Prior authorization rejected? You have powerful appeal rights. 83% success rate for properly appealed claims. Learn how to fight denials, navigate the appeal process, and win your coverage.
Tell us about your denial and we'll provide specific appeal strategies
Get expert guidance on fighting your insurance denial
Know the types of denials and why they happen
Insurer claims treatment not medically necessary or appropriate
Treatment labeled as experimental or not proven effective
Pre-approval required but denied or delayed indefinitely
Provider not in network or balance billing disputes
Treatment excluded from coverage in plan documents
Detailed denial reason with specific plan provisions cited
At least one level of appeal within insurance company
Independent review if internal appeal fails (binding on insurer)
Fast-track appeals (72 hours) for urgent medical situations
Right to see all documents used in denial decision
Key Insight: Studies show that 50-80% of insurance denials are overturned on appeal, revealing that many initial denials lack legitimate medical justification.
Specific strategies for the most frequent insurance denial scenarios
Navigate internal and external appeals to win your coverage
First level - within insurance company
Independent review - binding on insurer
If external review fails or isn't available
SB 1120 prohibits AI-only claim denials - a major victory for patient rights
Federal and state laws governing health insurance denials
Your appeal process and rights vary by state - know your specific protections
Independent medical review with 75-90% patient success rate
When insurers act in bad faith, you may have additional legal remedies
Missing a deadline can forfeit your rights - mark these on your calendar
Expert answers to common health insurance denial questions
Get expert guidance on appealing your health insurance denial and winning your coverage