Healthcare · Denials and appeals
Denials that don't hold up, caught with evidence.
A check of each denial against the official coverage rule, with signed evidence for the appeal.
of prior-authorization denials (13%) and payment denials (18%) in Medicare Advantage met Medicare's coverage rules.1
of 48.3 million in-network claims denied by ACA marketplace insurers in 2021 were appealed — and 41% of those appeals overturned the denial.2
a year is what U.S. hospitals are estimated to spend fighting denied claims.3