How do insurance denial appeals work?

Upload your denial letter and Lysco analyzes it, identifies the denial reason, cites applicable laws (ACA, ERISA, state regulations), and generates a customized appeal letter. You review and submit it yourself.

What is the success rate for insurance appeals?

It varies by plan type. For ACA marketplace plans, about 44% of appealed denials are overturned (KFF, 2023). For Medicare Advantage, it can be as high as 83% (HHS OIG). Many denials stem from billing or administrative errors that get fixed when challenged. Individual results vary.

Is Lysco a law firm or medical practice?

No. Lysco is an informational tool that helps you understand your rights and options. It is not a law firm, medical practice, or insurance company. For specific legal or medical situations, consult a licensed professional.

How much does Lysco cost?

Analysis is always free and your first appeal letter is free too. Upgrade to Pro ($29/mo) or Annual ($199/year) for unlimited appeal letters, insurer playbooks, and benefits finder. Cancel anytime.

Is my health data secure on Lysco?

Yes. Lysco uses AES-256 encryption at rest, TLS for data in transit, and row-level security so only you can access your data. We never sell your data and follow HIPAA-aligned security practices.

Diagnostic Imaging Denial

Humana Denied Your MRI Scan?

Humana Inc. denies 14.2% of claims on average. But 56% of appeals succeed when patients fight back. Your mri scan denial may have grounds for a successful appeal.

Analyze Your Denial Free Read the Appeal Guide

14.2%

Denial Rate

56%

Appeal Success

30-45 days

Typical Timeline

$1,200–$5,000

Typical Claim

Why Humana Denies MRI Scan

Prior authorization required but not obtained

Deemed not medically necessary at this stage

Lower-cost imaging (X-ray, CT) not tried first

Humana's Common Denial Tactics

Incorrect CPT/ICD coding as basis for denial

Claiming services duplicate prior treatments

Denying rehabilitation services as "not improving"

How to Win Your MRI Scan Appeal

Clinical notes explaining why MRI is specifically needed over other imaging

Documentation of symptoms warranting urgent imaging

Peer-to-peer review between ordering physician and insurer medical director

Laws That Protect You

ACA §2719 — Right to appeal imaging denials

No Surprises Act — Protection against balance billing

State laws requiring timely authorization decisions

Tips for Appealing to Humana

Verify CPT and ICD-10 codes match the services rendered

Get your provider to document functional improvement goals

For Medicare Advantage, cite CMS guidelines on coverage determination

Ready to Fight Your MRI Scan Denial?

Upload your denial letter and get an AI-powered analysis in minutes. We'll identify the weaknesses in Humana's reasoning and build your appeal strategy.

Analyze My Denial Free

Analysis is always free. No credit card required.

This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.