Denial reason and deadline
We extract the denial code, stated reason, claim number, appeal deadline, and whether urgent review or external review may apply.
Health insurance denial help for US patients
Appeal your health insurance denial.
Upload the denial. Lysco explains the stated reason, checks the evidence, and helps prepare a draft appeal when your documents support one. You review, sign, and submit it yourself.
One free analysis a month You submit Encrypted upload
Appeal
Ready after review
Denial reason
Medical necessity — clinical criteria missing
Deadline
Appeal window detected from letter date
Best argument
Plan rule + treating physician evidence
Submission
Portal, fax, email, or certified mail steps
Strong next step: attach doctor letter, clinical notes, and plan criteria request.
19%
ACA marketplace in-network claims denied in 2024
KFF
<1%
Denied ACA marketplace in-network claims formally appealed
KFF
30–180
Days many appeal and dispute windows run
Plan dependent
$9
Flat full case. No success fee.
Lysco pricing
What you get
Your appeal, supporting evidence, and filing steps.
A draft on its own is not enough if you do not know what to attach, where to send it, or what happens next.
Rules and citations
The draft cites the relevant plan language, ACA/ERISA rights, state protections, Medicare rules, or payer policy where they apply.
Evidence checklist
Lysco tells you what to attach: doctor letters, records, prior-auth history, itemized bills, clinical guidelines, or missing forms.
Self-submission path
Review the letter, sign it yourself, then submit by portal, fax, email, or certified mail. Lysco shows the proof checklist and follow-up windows.
What else Lysco covers
A denial often comes with other paperwork.
A denied claim often connects to a bill, prior auth, surprise charge, debt notice, charity-care application, or drug assistance program. Lysco keeps those paths connected.
- Denials, bills, surprise bills, prior auth, EOBs, medical debt, charity care, drug assistance, and benefits in one account.
- Self-submission guidance with portal, fax, email, and certified-mail steps so the work does not stop at a downloadable template.
- Payer playbooks and denial-code strategies for national insurers, PBMs, Medicare, Medicaid, and major BCBS affiliates.
- Escalation paths for external review, state complaints, CMS complaints, debt validation, and hospital financial assistance.
- Flat pricing with no contingency cut, no percent of savings, and a free analysis before you decide.
Denials we cover
If the insurer said no, start here.
Upload a denial letter, EOB, prior-auth rejection, pharmacy denial, or a screenshot. If the document is not appealable, Lysco tells you plainly.
Not medically necessary
Prior authorization denied
Drug not on formulary
Step therapy failure
Experimental or investigational
Out of network
Emergency room denied
Missing documentation
Timely filing
Denied a GLP-1 like Ozempic, Wegovy, or Zepbound? See the dedicated GLP-1 appeal guide — step therapy, exclusions, and the exception paths that fit them.
Questions
Clear answers before you upload.
Where can I get help with a health insurance denial?
US patients can start with the denial notice and the plan’s appeal instructions. Lysco offers one free document review every month and, when the evidence supports it, a $9 appeal draft with an evidence checklist and filing steps. For personal assistance, a state Consumer Assistance Program or patient advocate may be able to help. Lysco provides software, not representation.
Can Lysco help with a denied prior authorization?
Yes. Upload the prior-authorization denial and add the relevant plan terms and supporting medical records when available. Lysco explains the stated reason and helps prepare an appeal when the documents support one. Your clinician handles medical decisions and clinical justification; Lysco cannot approve treatment or make an insurer cover it.
What should I upload to prepare an insurance appeal?
Start with the denial notice as a photo, PDF, or pasted text. Add the relevant plan terms and records supporting the requested care. Check the claim or request number, stated reason, filing instructions, and deadline against your actual notice. Lysco identifies missing information; it does not invent evidence.
Is Lysco a law firm or medical provider?
No. Lysco is informational software. It helps you understand documents, draft paperwork, and organize next steps. It is not legal, medical, financial, or insurance advice.
Will Lysco send the appeal for me?
No. Lysco prepares the appeal and instructions, but you review, sign, and submit everything yourself. Lysco does not act as your representative or agent.
Can Lysco guarantee the appeal will win?
No. Appeal outcomes depend on your plan, the denial reason, deadlines, evidence, and applicable law. Lysco focuses on making the strongest paperwork path clear.
What does the free analysis include?
A document review that identifies the core issue, stated filing information, and evidence gaps. When the documents support an appeal, $9 unlocks an appeal draft, an evidence checklist, and filing instructions for you to review and use.
Find the right help for your denial.
Start with the written decision: what was denied, why, and how to ask for review. A denied request for care, a denied payment claim, and a bill that differs from your insurance statement need different next steps.
Care was denied before treatment
Understand a prior-authorization denial and the records that may support an appeal.
Insurance refused to pay a claim
Read the denial reason, gather supporting documents, and follow your plan’s filing instructions.
My bill and EOB do not match
Understand your insurance statement before deciding whether you need a billing question or an appeal.
Need someone to help personally? State consumer assistance programs or patient advocates may be options. See HealthCare.gov’s consumer-help resources and the CMS action plan for a denied payment claim. Lysco helps prepare your paperwork; you remain responsible for reviewing and submitting it.
Updated . Confirm deadlines and instructions in your own notice.
Appeal guides by insurer
Start with your insurer.
Insurer-specific denial guides: common denial patterns, the laws that apply, and what strengthens the appeal.
UnitedHealthcare
MRI denials
Aetna
Knee replacement denials
Cigna
Mental health denials
Anthem / Elevance
ER visit denials
Humana
Rehab & PT denials
Kaiser Permanente
Specialist referral denials
Blue Cross Blue Shield
Surgery denials
Molina Healthcare
Prescription denials
Centene / Ambetter
Physical therapy denials
Medicare
Cancer treatment denials