Dispute Guides

Insurance Denial & Dispute Library

Select an active administrative guide below. New carrier, denial-code, and state guides will appear here as they are validated.

A carrier guide is a starting point, not a substitute for what's actually printed on your denial notice. The same national carrier might administer fully insured employer coverage, self-funded employer benefits, individual coverage, Marketplace plans, Medicare Advantage, Medicaid, pharmacy benefits, and behavioral-health benefits, and those products can run on entirely different deadlines, forms, review levels, and submission channels.

Carrier Dispute Guides

  • Cigna Appeal Process

    General guidance describes a 180-calendar-day window for many appeals, and notes that state requirements can differ.

  • UnitedHealthcare Appeal Process

    Confirm whether this is pre-service, post-service, a grievance, a pharmacy issue, or an employer-plan claim before you go further.

  • Aetna Appeal Process

    Aetna's own member guidance cites a 180-day appeal window unless the plan brochure or SPD gives more time, but your own notice and plan documents control.

  • Blue Cross Blue Shield Appeals

    BCBS is a federation of independent local companies. Identify the specific company named on your ID card and EOB, and use that company's instructions.

  • Humana Appeal Process

    Humana runs several distinct product lines. Commercial members should lean on the denial notice, member portal, ID card, and plan document rather than a generic national route.

For any carrier, start pulling together the same core documents: the denial notice, EOB, member ID card, claim number, date of service, plan document or SPD, supporting records, the deadline, and current carrier instructions. And before you escalate anywhere, confirm the plan type, because the carrier logo alone won't tell you whether the plan is fully insured or self-funded, and that distinction changes the regulator, the external-review process, and the employer's role.

Denial Codes & Reasons

Procedure Appeal Guides

State Patient Rights

Administrative Tools & Resources

Common Questions

Carrier Guide FAQ

Can I use the same appeal form for every plan from one carrier?

No. Different product lines and states can use different forms and procedures.

Where should I fax my appeal?

Use the destination in the denial notice, EOB, member portal, or current plan instructions, not a number found elsewhere.

Is BCBS one insurance company?

No. Local BCBS companies operate independently under the national association.

Does the carrier determine my appeal deadline?

No. The deadline comes from the applicable plan and legal framework, and it should be printed on the denial notice.