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Understand your denial and how to appeal it
Clear, practical guides to health-insurance appeals: which type you need, the deadlines that matter, and the step-by-step process. Free to read, and we're here if you'd rather have us handle it.
A denial is not the end of the road. Most appealed denials are overturned, but the process is full of strict deadlines, dense policy language, and rules that change depending on how your plan is regulated. These guides break it down by situation so you can act with confidence.
Start here
Not sure where to begin?
Pin down your appeal type, the deadlines, and the vocabulary first.
Which appeal do I need?
Identify your denial type and the right appeal path before you do anything else.
Compare appeal typesAppeal deadlines
The filing windows and response times that decide whether your appeal even counts.
Read guideGlossary
Plain-English definitions: ERISA, IDR, QPA, SPD, medical necessity, repricer, and more.
Browse termsAppeals by type
Guides for each kind of appeal
The rules differ by how your plan is regulated. Find the one that matches your coverage.
ERISA appeals (employer plans)
The 3-level internal-and-external appeal process that governs most employer-sponsored coverage.
Read guide72-hour urgent ERISA appeal
How to expedite an appeal when waiting for the standard timeline would jeopardize your health.
Read guideACA / Marketplace appeals
Internal appeals and independent external review for ACA marketplace coverage.
Read guideSurprise bills (No Surprises Act)
What to do about surprise and balance bills under federal No Surprises Act protections.
Read guideOut-of-network underpayments
When the claim was paid, just not enough
Insurers often use third-party repricers to underpay out-of-network claims. These guides show how to identify and appeal them.
Out-of-network underpayments
When insurers underpay out-of-network claims using third-party repricers, and how to push back.
Read guideZelis
Spot Zelis repricing on your EOB and run the two-step appeal to recover the underpayment.
Read guideMultiPlan / Claritev
Per-platform guidance for MultiPlan / Claritev out-of-network underpayments.
Read guideData iSight
Appeal the insurer, not the vendor: how to challenge a Data iSight repricing.
Read guideHelp & background
Answers and context
Quick answers, definitions, and the bigger picture behind insurance denials.