Fundamentals
How to Read and Understand Your Insurance Denial Letter
Every denial letter must legally contain specific information. Learn what to look for and how to use it in your appeal.
Generate letters, calculate deadlines, decode your EOB — all free, no sign-up.
Most insurance plans require you to file an internal appeal within 180 days of receiving a denial. Some state plans have shorter deadlines. Calculate your exact deadline now →
The most common denial types — each requires a different appeal strategy.
Your insurer refused to pre-approve a treatment. This is the most common denial type — and highly appealable. Over 60% of prior auth appeals succeed.
Guide to Prior Auth Appeals →Your insurer claims the treatment isn't "medically necessary." Counter this with peer-reviewed evidence, physician letters, and clinical guidelines.
Guide to Medical Necessity →Received care from an out-of-network provider? Emergency care has strong federal protections. Non-emergency OON appeals also succeed regularly.
Guide to OON Appeals →Incorrect billing codes are responsible for up to 30% of denials. These are often the easiest to fix — a single corrected claim can resolve the denial.
Guide to Coding Error Appeals →The appeal process is more straightforward than you think. Here's how it works.
Read your denial letter carefully. Identify the denial code and reason. Use our EOB Decoder if needed.
Different denial types need different approaches. Read the relevant guide and use the appeal quiz.
Use our Letter Generator to create a professional letter with regulatory citations specific to your situation.
Send your appeal via certified mail or the insurer's portal. Track your deadlines and escalate to external review if needed.
Expert guides to help you navigate every step of the appeal process.
Every denial letter must legally contain specific information. Learn what to look for and how to use it in your appeal.
KFF data shows 60%+ of prior auth appeals succeed. Here's the exact strategy that works, with template language and regulatory citations.
The MHPAEA requires insurers to cover mental health at the same level as physical health. Many denials violate this law — here's how to cite it.
Our generator creates complete, professionally written appeal letters in minutes — not hours.
Every letter cites the specific federal and state regulations that support your appeal — ACA, ERISA, and more.
All tools run in your browser. We never store or transmit your medical or insurance information.
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