Paste the denial
Upload the EOB or paste the denial reason code (e.g., CO-50, PR-204) and any explanation the insurer gave.
Insurance appeal
Your insurance denied the claim. Here's how to fight it.
Some denials can be corrected or appealed when the denial reason and evidence line up. We help you draft a formal internal appeal in plain English for $19, or upgrade to a Full Audit if the bill itself looks wrong too.
Why claims get denied
Six common reasons to review.
Most insurance denials fall into six buckets. A denial is not always the end, but the next step depends on your plan, deadline, and evidence.
- Coverage / benefits - insurer says the service is not covered under your plan. Check the benefit language before appealing.
- Medical necessity - insurer says the service was not medically necessary. Provider documentation may be needed.
- Pre-authorization - service required prior approval. Ask who was responsible for requesting it.
- Out-of-network - service billed as out-of-network. Check whether surprise-billing protections may apply.
- Coding error - wrong CPT, modifier, or diagnosis code. Ask whether provider coding review should happen first.
- Duplicate - claim looks like a duplicate. Submit documentation showing the correct date of service.
Many plans list appeal deadlines and submission instructions on the EOB or denial notice. Confirm that deadline first, then file through the route your plan specifies.
How the $19 generator works
Three minutes. One tailored letter.
Tell us your plan type
ACA marketplace, employer fully-insured, employer self-funded, Medicare, Medicaid, or government program. The generator keeps the appeal language cautious when the route is uncertain.
Get the letter
A formal internal appeal draft, provider-document request, insurer call script, and external-review prep notes emailed to you and shown on screen.
FAQ
Common questions.
How is this different from the $29 Resolution Pack?
The $19 Appeal Generator focuses on one insurance denial and drafts an internal appeal to the insurer. The $29 Resolution Pack handles the broader bill, including bill-versus-EOB comparison, provider scripts, and dispute letters.
Will an appeal definitely work?
No. Appeal outcomes depend on your plan's coverage, the denial reason, the medical documentation, and the insurer's review.
How long does the insurer have to respond?
The timing depends on your plan type and whether the appeal is urgent, pre-service, or post-service. Confirm the exact deadline and response window from the denial notice or plan documents.
What if my internal appeal fails?
You may have an external review or complaint route depending on plan type and denial reason. The Appeal Generator includes prep notes for that step.
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