They Said No. That Doesn't Mean It's Over.
A denial is not a final answer. It's a starting point. Most people give up after the first no — and that's exactly what insurance companies are counting on. Bean is here to show you how to fight back.
Get Help With Your Denial200M+
Claims denied annually in the US
40%
Of appealed denials are overturned
<1%
Of patients actually appeal
Why They Denied You — And the Truth Behind It
Not Medically Necessary
This is the #1 denial reason — and it's often wrong. Your doctor says it's necessary. The insurance company disagrees. You can fight this.
Prior Authorization Not Obtained
Sometimes the doctor's office forgot. Sometimes the insurer changed the rules. Either way, you have appeal rights.
Out-of-Network Provider
If you had no in-network option or it was an emergency, you may have grounds for an appeal or a surprise billing protection claim.
Experimental or Investigational
Insurers use this to deny cutting-edge treatments. Clinical evidence and your doctor's letter can overturn this.
Coding Error
A wrong billing code can trigger an automatic denial. Request the itemized bill and check every code.
How to Appeal — Step by Step
Follow these steps in order. Document everything.
Get the denial in writing
Request the Explanation of Benefits (EOB) and the denial letter. You need the specific reason code.
Review your policy
Find the exact language in your policy that covers what was denied. Highlight it.
Get a letter from your doctor
Ask your doctor to write a letter of medical necessity. This is your most powerful tool.
File the internal appeal
Submit within the deadline (usually 180 days). Send everything certified mail. Keep copies of everything.
Request external review
If the internal appeal fails, you have the right to an independent external review. Insurers lose these more than you'd think.
Escalate if needed
File a complaint with your state insurance commissioner. This gets attention fast.
Don't Miss the Deadline
Deadlines vary by plan and state. Always check your specific policy and denial letter.
Don't Fight This Alone
Bean has navigated the claims and appeals process firsthand. She knows the system — and she knows how to push back.