Visa · Insurance · University · Benefits · Any denial, anywhere
Paste the letter they sent you. We’ll read what they actually meant and help you write back.
Built by someone who went through this with their own family, and after countless conversations with others fighting the same battle, decided to actually do something about it. Most people don’t have a lawyer on retainer. This won’t replace one when you genuinely need one, but it gives you a real, specific starting point instead of a blank page.
What you receive
The letter we're appealing
Everything below, the findings, the deadline, the draft, responds to this exact letter.
Dear Member,
We have reviewed your claim referenced above and have determined that the requested service does not meet our medical necessity criteria as outlined in Clinical Policy Bulletin #0148, Section 3(b).
Claim Reference: INS-4471920
Service: MRI, Lumbar Spine (CPT 72148)
Date of Service: October 14, 2025
Determination: Denied
You have the right to appeal this decision within 180 days of this notice.
Sincerely,
Claims Review Department
What you walk away with
Not a template. Written for your denial, your grounds, your situation. Here’s what one looks like.
Generated from the sample denial letter shown earlier on this page. Yours would be written around your specific letter, grounds, and situation.
Your report includes
Ready to see it for yours?
Three things Appealify found in that letter
Not the official version. The version you need to respond to.
Medical necessity denials are challenged more often and overturned more often than any other reason, when the right documentation is in place. Your doctor’s records are the key.
Request Clinical Policy Bulletin #0148 in writing. Then ask your doctor to write a letter addressing Section 3(b) point by point. That’s not general pushback; it’s a direct answer to their stated reason.
Filing early signals you take this seriously and gives your doctor sufficient time to prepare documentation. The 180-day window is your legal right. The 30-day window is your strategic advantage.
The scale of the problem
Insurance claims denied on US health plans in 2024, one country, one decision type, and fewer than 1% were appealed. Add visa refusals, university rejections, and benefit denials worldwide, and the true scale is far larger. Most are never challenged.
Accept it. Give up. Move on. Because the letter was written to make that feel like the only option.
Across insurance, immigration, universities and benefits, appeals and reviews succeed far more often than people expect. Most denials are never challenged.
After we’ve read your decision
Not every decision uses the same process. Appealify identifies which routes are available to you and which is most likely to succeed.
A formal written challenge sent back to the organization that denied you. Reviewed internally. The first and most common route, and the one to take first before any others open.
Best when: you have medical, academic, or professional documentation to support your case.
An independent third-party review body examines the decision. For insurance denials in the US, this is a legal right. The decision is binding on the insurer; they cannot override it.
Best when: the internal appeal fails, or when the decision involves a medical judgment the insurer’s own reviewers may be biased on.
Depending on your denial type and jurisdiction, additional routes may exist: ombudsman referrals, regulatory complaints, reconsideration requests, or new applications with strengthened evidence.
Best when: the standard appeal routes are exhausted, or when the denial has procedural grounds that warrant escalation.
What Appealify is
A document analysis and drafting tool. We read your denial, explain what it means in plain language, identify your strongest grounds, and write a complete appeal you can review and send, for any denial type, in any country.
A law firm, insurer, immigration consultancy, or government body. We do not provide legal, medical, immigration, or financial advice. For decisions with serious legal or financial consequences, we recommend also speaking with a qualified professional.
One decision. One payment. No account required, for customers anywhere in the world.
Start here
Paste the letter. See what it actually means. Then decide what you want to do about it.
↑ Click to paste your letter in the tool above