Denials
Claim Appeals
Levels of appeal, deadlines, evidence, and letters that get overturned.
An appeal is an argument, and payers overturn arguments that quote their own policy back to them with the documentation attached. Everything else is a form letter.
This section covers the appeal levels for Medicare, Medicaid, and commercial plans, what evidence each level expects, how peer-to-peer review works, and templates you can adapt for the denial types that recur most.
More on denials and appeals
Denial code breakdowns, appeal letter structure, and root-cause patterns, published as we work through the code set.
Browse denial codes