Frequently Asked Questions
Answers to the questions we hear most often.
What is an appeal?
An appeal is a formal request asking your insurance company to reconsider a claim decision. Federal law and most state regulations require insurers to maintain an appeal process. That requirement exists because initial determinations are not always accurate.
An appeal gives you the opportunity to submit additional information, correct errors, or challenge the reasoning behind the denial.
Do appeals actually work?
For Medicare Advantage prior-authorization denials specifically, 80.7% of appealed denials were fully or partially overturned in 2024 (KFF, July 2025). For ACA marketplace plans, insurers upheld 66% of internal appeals in 2024, meaning roughly a third were reversed in the patient's favor (KFF, March 2026).
The reason most people never see those numbers is that, in 2024 data from HealthCare.gov plans, consumers appealed fewer than 1% of denied claims. The documentation and process requirements are enough to stop most people before they start. That's the gap we fill.
Why only $49?
Most denied claims fall into a difficult range. Too large to pay without question. Too small to justify attorney fees.
Remedy Support was built specifically for people facing bills between $500 and $10,000. At $49, the fee is a fraction of the amount being contested.
What types of claims do you handle?
Remedy Support is optimized for commercial health insurance denials, including employer-sponsored plans and Medicare Advantage plans administered by commercial carriers like UnitedHealthcare, Aetna, Cigna, Humana, and BCBS.
We programmatically process two primary classes of rejections: Medical Necessity Denials (Claim Code CO-50) strictly for high-tech diagnostic imaging services, including MRIs, CT scans, and PET scans with CPT codes 70010 through 79999; and Missing Prior Authorization Denials (Claim Code CO-197), where a provider performed a service or procedure without securing pre-service certification.
We do not handle inpatient hospital stays, out-of-network balance bills, experimental or investigational procedures, non-covered benefit exclusions, or disputes involving traditional government-administered Medicare or Medicaid. If your denial falls into one of these categories, our intake panel will redirect you prior to payment.
Do I need a lawyer?
For most health insurance claim appeals, no. The appeal process is administrative, not legal. It does not typically require an attorney.
Remedy Support handles the complete administrative appeal process, including drafting, specialist review, and direct transmission to your carrier. If your situation escalates beyond the insurer's internal process, such as external review or litigation, that is a separate matter.
What documents do I need?
Start with your denial letter. If you have your Explanation of Benefits from the insurer, include that. Any clinical documentation from your provider supporting the medical necessity of your care is also helpful.
You don't need everything organized before you start. We review what you have and identify what may be missing.
Who reviews my case?
Every appeal is reviewed by a trained appeals specialist before transmission to your carrier. They examine the appeal for completeness, accuracy, and compliance with your carrier's specific requirements.
How long does this process take, and is there a deadline limit?
Most appeal packets are compiled, verified by a clinical specialist, and transmitted to your carrier within 3 business days.
However, we enforce a strict 5-business-day deadline gate at intake. Health insurance carriers enforce hard filing deadlines that vary by carrier, plan, and appeal type, commonly in the 60- to 180-day range from your denial notice or EOB, and our platform requires manual verification steps to guarantee packet delivery, so we cannot accept any cases that have fewer than 5 business days remaining before the carrier's appeal deadline.
Why don't you handle out-of-network or experimental treatment appeals?
Out-of-network disputes require complex, highly subjective network-adequacy and geographic rate-gap exception arguments. Experimental, investigational, or non-covered plan exclusion disputes rely on clinical policy and benefit design judgment fights.
These case types cannot be programmatically standardized. To keep our fee flat at $49 and guarantee consistent administrative accuracy, we strictly limit our operations to high-tech imaging and prior-authorization errors, scenarios where carrier rules are objective and heavily bound by federal regulations.
Is my private medical information secure on your platform?
Yes. Your denial letter, medical charts, and other files are transmitted over an encrypted connection and stored within a protected vault architecture. Access is limited to the authenticated systems and personnel involved in preparing and reviewing your appeal.
The automated tools used to help match your denial to relevant policy language work from de-identified information, such as procedure and diagnosis codes, rather than your name or other directly identifying details.
What is the difference between a Remedy Support appeal and a free template?
Free online templates generate a text letter. On their own, they don't include the authorization forms, HIPAA disclosure, or delivery documentation many carriers expect before treating a submission as a formal clinical appeal rather than a general member grievance.
Remedy Support compiles a complete Authority Packet. This includes a customized clinical appeal letter, the authorization materials required for your plan when available, a HIPAA disclosure authorization, and carrier-specific representative forms, such as Cigna Form 979070. The completed packet is then routed through an accepted carrier channel.
What if the appeal doesn't succeed?
We do not guarantee outcomes. Some denials are ultimately valid. Others may require escalation beyond the internal process, to an external review organization or your state insurance regulator.
If your internal appeal is unsuccessful, we will outline the next steps available to you.