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.

Can Lysco predict my appeal result?

Appeal outcomes vary by plan, facts, and documentation. Public data shows consumers rarely appeal denied claims and many denials involve administrative or plan-design issues. Lysco helps users understand the denial, prepare the paperwork, and decide what to do next; it does not predict results.

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?

EOB translation is always free and you get one free document analysis and one free appeal letter. Per case: $29 for a denial appeal, medical bill review, or surprise bill dispute. Or upgrade to Pro ($29/mo) or Annual ($199/year) for unlimited everything across all five pillars including the prior authorization helper. 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.

Diagnostics Denial

Medicare Denied Your Lab Work / Diagnostic Testing?

According to federal data, Centers for Medicare & Medicaid Services (CMS) denies approximately 18% of claims. When patients appeal, about 75% are overturned. Your lab work / diagnostic testing denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.

Analyze Your Denial Free Read the Appeal Guide

18%

Denial Rate

75%

Appeal Success

60-90 days

Typical Timeline

$200–$5,000

Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why Medicare Denies Lab Work / Diagnostic Testing

Test not indicated based on diagnosis code

Duplicate testing within coverage period

Experimental or investigational test classification

Medicare's Common Denial Tactics

Denying claims as not reasonable and necessary

Coverage determinations based on LCD/NCD criteria

Denying skilled nursing facility stays as custodial care

How to Win Your Lab Work / Diagnostic Testing Appeal

Physician order with specific clinical indication

Evidence test results changed treatment plan

Published clinical guidelines recommending the test for the diagnosis

Laws That Protect You

ACA — Preventive services coverage

CLIA standards for laboratory testing

State genetic testing protection laws

Tips for Appealing to Medicare

Medicare has a 5-level appeal process — most denials are overturned by level 2 or 3

Request an ALJ hearing if redetermination and reconsideration fail

Cite specific LCD/NCD criteria and explain how your case meets them

Ready to Review Your Lab Work / Diagnostic Testing Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in Medicare's reasoning and outline your appeal options.

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.