Insurance Denial Navigator
Fewer than 1 in 10 insurance denials are appealed — and a majority of appealed claims are reversed. This tool walks through your specific denial type and gives you the exact steps, deadlines, and legal language for an effective appeal.
This tool provides general guidance, not legal advice. For complex cases or large dollar amounts, consider a patient advocate or healthcare attorney.
<1 in 10
Denied claims that are ever appealed
40–60%
External appeals that overturn the denial
72 hrs
Expedited external review turnaround for urgent/life-threatening cases
Insurance Denial Navigator
What type of denial did you receive?
Check the Explanation of Benefits (EOB) or denial letter for the exact denial type.
This tool provides general guidance, not legal advice. Consult a patient advocate or healthcare attorney for complex cases.
Need more help?
Patient Advocate Foundation
Free case management for insurance denials — assigns a case manager to work through your specific situation.
State Insurance Commissioner
File a complaint when you believe the insurer has acted improperly. Regulators track patterns.
ACA External Review (CMS)
Your federal right to independent external review — free, binding, and 40–60% overturn rate.
Teaching healthcare rights and AI denials?
The educator guide includes facilitation notes for the denial navigator, discussion questions on algorithmic accountability, and patient advocacy exercises.