How to fight a denial — by treatment, drug, or reason.
Plain-language playbooks. The exact policy citations and counter-arguments insurers respect, written by people who’ve done it.
Featured
Browse by treatment
90 guides — every treatment we cover, with the policy citations and counter-arguments to use.
Adult ADHD medications
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Adult CAR-T cell therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Amyloidosis (cardiac ATTR + AL)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Asthma & severe allergies
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Atopic dermatitis (AD / eczema)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Autoimmune cytopenias (ITP + AIHA)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Bariatric surgery — RYGB, sleeve, duodenal switch, SADI-S, revision, ESG
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Bone marrow transplant (allogeneic HSCT)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →BPH procedures + medical therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →C. difficile infection
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Cancer treatments
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Cardiac devices & procedures
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Cardiology drugs
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Chronic wound care
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Compounded GLP-1
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Compounded medications (non-GLP-1) — BHRT, LDN, ketamine, custom-dose pediatrics
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Continuous glucose monitors & insulin pumps
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →COPD severe + alpha-1 antitrypsin deficiency
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Cystic fibrosis & pulmonary fibrosis
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Dental — medical necessity, oral surgery, TMJ, cleft palate
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Diabetes drugs & insulin
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →DME — wheelchairs, prosthetics, orthotics
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Eating disorders — residential / PHP / IOP
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Endocrine (non-diabetes)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →ENT / Otolaryngology — sinus surgery, septoplasty, tonsillectomy, head & neck
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Eosinophilic esophagitis (EoE)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Fertility & IVF
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Genetic testing
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →GERD & severe reflux
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Glaucoma (drops + procedures + surgery)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →GLP-1 weight-loss drugs
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Growth hormone replacement therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Hearing aids, cochlear implants, BAHA
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Hemophilia & bleeding disorders
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Hepatitis C cures
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Hereditary angioedema (HAE)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →HIV PrEP & HIV treatment
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Home healthcare — home nursing, home infusion, home PT/OT/SLP, home aide, hospital-at-home
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Hospice / palliative — eligibility, GIP, recertification, concurrent care
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →IBS & functional GI
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Immune globulin (IVIG/SCIG) for PIDD
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Inflammatory bowel disease (Crohn's + UC)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Inpatient rehab — IRF / SNF / LTAC admission and length-of-stay
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Interventional pain — SCS, RFA, ESI, kyphoplasty
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Interventional radiology — UFE, PAE, TIPS, Y-90, tumor ablation, kyphoplasty
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →IV iron infusion
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Kidney disease — CKD, ESRD, IgAN, ADPKD
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Liver (non-HCV) — NASH/MASH, PBC, AIH, Wilson
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Long COVID / PASC
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Lupus & rheumatology
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Lymphoma & leukemia (heme malignancies)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Maternity & postpartum
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Melanoma & melanoma-immunotherapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Men's sexual health — TRT + ED
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Mental health & behavioral health
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Migraine CGRP inhibitors
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Mohs surgery & dermatologic surgery — BCC, SCC, melanoma in situ, SLNB, PDT
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →MS treatments
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Multiple myeloma (non-CAR-T)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Myasthenia gravis & CIDP
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Neurology — Alzheimer's, Parkinson's, ALS, epilepsy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Neuropsychological & psychological testing — ADHD, TBI, dementia, ASD, presurgical eval
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Neurosurgery — discectomy, laminectomy, craniotomy, shunt
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Orthopedics & sports medicine
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Osteoporosis
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Out-of-network emergency
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Pediatric epilepsy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Pediatric oncology
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Pediatric subspecialty — cardiology, GI, pulmonology, rheumatology, endocrinology, neurology
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Pediatric therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Plaque psoriasis + psoriatic arthritis
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Prostate cancer
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Pulmonary hypertension
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Radiation oncology — proton, SBRT, brachytherapy, IMRT, IORT
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Rare disease — ERT, substrate reduction, gene therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Reconstructive plastic surgery — lymphedema, panniculectomy, burn, Mohs, hand
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Severe acne
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Sickle cell & thalassemia
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Sleep medicine — CPAP, BiPAP, ASV, oral appliances, Inspire HNS
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Solid-organ transplant
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Specialty biologics
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Spinal muscular atrophy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Stroke & neuro rehab
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Substance use disorder treatment (SUD/MOUD)
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Surgery denied as 'not medically necessary'
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Thyroid eye disease (TED) — Tepezza (teprotumumab) and IGF-1R therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Treatment-resistant depression — rTMS, Spravato, ECT
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Vascular & endovascular — AAA, carotid, PAD, varicose veins, IVC filters
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Vision & retinal — anti-VEGF, GA, gene therapy
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →Women's health — menopause, endometriosis, PCOS, PPD
Organization guide for this denial type. The current notice, plan documents, and verified case facts determine the supported route.
Read guide →