Health insurance denial appeals
Upload your denial letter. We draft your appeal with the federal appeal rules for your plan and your state's law where it applies, plus who to copy and your filing deadline.
You check every detail we read, and you send the appeal yourself. We never contact your insurer.
See a sample appeal first (fictional case) →“The service is not medically necessary based on the information we received.”
“I ask Evergreen Test Health Plan to identify the information it relied on and the specific reason it found the physical therapy not medically necessary for me.”
Cites 45 CFR 147.136 · plus a Next Steps sheet: where to send it, the deadline, who to copy
Fewer than 1 in 100 denied claims are ever appealed (KFF, 2024 HealthCare.gov data). See the data ↓
A sample appeal (fictional patient)
Jordan received a denial for 12 physical therapy sessions. (Jordan, the plan and every number are fictional test data.)
Before — the denial
Evergreen Test Health Plan
Re: Notice of claim denial
Service denied: Outpatient physical therapy, 12 sessions
You must file your appeal within 180 days of the date of this letter.
Reason given
"The service is not medically necessary based on the information we received."
That's the entire reason. It doesn't say what information was missing.
After — the appeal we drafted
RE: Appeal of denial — Outpatient physical therapy, 12 sessions
“First, the denial says it relied on ‘the information we received.’ It does not say what information was reviewed or what was missing. I ask Evergreen Test Health Plan to identify the information it relied on and the specific reason it found the physical therapy not medically necessary for me.”
“…Under 45 CFR 147.136(c), if a State external review process applies to and is binding on a health insurance issuer … then the issuer must comply with the applicable State external review process. My plan is an individual plan. I reserve my right to pursue external review if this appeal is not resolved in my favor.”
Where only Jordan or the doctor can supply something, the letter says so with a [PROVIDE: …] marker instead of inventing it. Plus: a Next Steps sheet — where to send it, the deadline as the denial states it, and who to copy (here, the Ohio Department of Insurance).
Appeal-Letter.docx · Appeal-Letter.pdf · Next-Steps.pdf
In your corner
A denial is a hard moment. We built this so the next moment can be a calmer one.
The moment it lands
A surprise letter. A looming bill. The instinct to give up. Most people stop here. We start here.
Working it out together
Upload the denial. We draft a clean appeal with the federal appeal rules for your plan, your state's law where it applies, and your filing deadline.
A calmer next moment
A letter you can edit, sign and send, plus a sheet that tells you where it goes.
Every denial has a playbook. Pick yours.
By insurer
UHC · UBH · Optum · NaviHealth
Appeal guidesCVS Health / Caremark
Appeal guidesEvernorth / Express Scripts
Appeal guidesElevance Health
Appeal guidesBy denial type
Federal 180-day ERISA window. State 30–60. Missing it ends the appeal before it starts. This calculator gives you the exact date.
Most denied claims are never appealed.
Under 1 in 100
denied claims were appealed in 2024 (KFF, HealthCare.gov plans)
3 files
Your appeal letter as Word and PDF, plus a Next Steps sheet: where to send it, the deadline, who to copy
$0
What AppealArmor costs you, now and always
Source: KFF, Claims Denials and Appeals in ACA Marketplace Plans in 2024 (March 24, 2026). HealthCare.gov marketplace plans only, not employer plans. KFF reports that fewer than 1% of denied claims were appealed and that insurers upheld 66% of denials on appeal.
We're in your corner.
Fewer than 1 in 100 denied claims are ever appealed. Most people never try, and the process is intimidating.
My wife June and I have triplets who needed 16 surgeries between them. I'm an AI researcher who got tired of fighting denials by hand, so I built this. You shouldn't need a law degree to fight for healthcare you've already paid for.
— Stuart & June Kerr
Yes. It is free for patients, with no account and no credit card. The one thing we ask is that you check the details we read from your denial letter before anything is written. We are an appeal-writing service, not a law firm, and we do not give legal advice.
Your denial letter, as a PDF, a photo or pasted text. We fill in what the letter tells us. You confirm your name, mailing address and email, the state you live in and the kind of plan you have, the insurer, what was denied, and the reason they gave.
An AI model reads your letter once, over an encrypted connection, to find the facts. Before your appeal is drafted, our server replaces your name, address, email, and your member, group, claim and authorization numbers with placeholders, and puts your real details back only in the files we email to you: your appeal letter and your Next Steps sheet. Your case is stored encrypted and deleted 31 days after it starts. We are not a HIPAA covered entity, so we do not claim to be HIPAA compliant. The rest is in our Privacy Policy.
No. We email the finished appeal to you. You read it, sign it and send it. We do not send anything to your insurer.
The letter cites the rules for your plan type, and the Next Steps sheet says where to send it. Individual plans and insured employer plans: the federal appeal rule 45 CFR 147.136, plus your state's law where it applies. Employer plans: also the federal claims rule 29 CFR 2560.503-1, and the Employee Benefits Security Administration is listed as a copy recipient. Self-funded employer plans: the federal external review rule, 45 CFR 147.136(d). Medicare Advantage: 42 CFR 422.582 and 422.590. Medicare Part D: 42 CFR 423.582. Medicaid: 42 CFR 438.402(c) and 438.408(f). For a government or church employer plan, or a plan we cannot place, the letter answers the reason your denial gives but adds no plan-specific citation.
Free. No account.
