{"id":2078398,"date":"2025-09-04T05:00:00","date_gmt":"2025-09-04T09:00:00","guid":{"rendered":"https:\/\/kffhealthnews.org\/?post_type=article&#038;p=2078398"},"modified":"2025-11-20T15:11:24","modified_gmt":"2025-11-20T20:11:24","slug":"health-insurance-denial-prior-authorization-7-tips-to-file-appeal","status":"publish","type":"article","link":"https:\/\/kffhealthnews.org\/news\/article\/health-insurance-denial-prior-authorization-7-tips-to-file-appeal\/","title":{"rendered":"Fighting a Health Insurance Denial? Here Are 7 Tips To Help"},"content":{"rendered":"\n<p>When Sally Nix found out that her health insurance company wouldn\u2019t pay for an expensive, doctor-recommended treatment to ease her neurological pain, she prepared for battle.<\/p>\n\n\n\n<aside class=\"block--sidebar alignright \">\n\t\n\n<div class=\"wp-block-kaiser-health-news-partner block--partner\">\n\t\t\t\t\t\t<a class=\"partner__image--link\" href=\"https:\/\/www.nbcnews.com\/health\/health-care\/prior-authorization-denied-health-insurance-fight-back-rcna226372\">\n\t\t\t\t<img decoding=\"async\" class=\"partner__image\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2022\/12\/NBC-News-Logo-2022.png?w=120\" alt=\"Partner logo\" \/>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t<p class=\"partner__content\">\n\t\tThis story also ran on <a href=\"https:\/\/www.nbcnews.com\/health\/health-care\/prior-authorization-denied-health-insurance-fight-back-rcna226372\">NBC News<\/a>. It can be <a href=\"https:\/\/kffhealthnews.org\/news\/article\/health-insurance-denial-prior-authorization-7-tips-to-file-appeal\/view\/republish\/\">republished for free<\/a>.\t<\/p>\n<\/div>\n\n\n\n<div class=\"is-style-classic  wp-block-kff-common-promo\">\n\t\t<div class=\"wp-block-kff-common-promo__inner\">\n\t\t\t\t\t<h3 class=\"wp-block-kff-common-promo__title\">\n\t\t\t\t<a class=\"wp-block-kff-common-promo__link\" href=\"https:\/\/kaiserfamilyfoundation.wufoo.com\/forms\/w19lp8m31l8mow5\/\">\n\t\t\t\t\tWe Want To Hear Your Story.\t\t\t\t<\/a>\n\t\t\t<\/h3>\n\t\t\t\t\t\t<p class=\"wp-block-kff-common-promo__excerpt\">Do you have experience with prior authorization you\u2019d like to share with us for KFF Health News&#8217; reporting? <a href=\"https:\/\/kaiserfamilyfoundation.wufoo.com\/forms\/w19lp8m31l8mow5\/\">Click here<\/a> to reach us.<\/p>\n\t\t\t\t\t\t<a class=\"wp-block-kff-common-promo__read-more wp-block-kff-common-promo__link\" href=\"https:\/\/kaiserfamilyfoundation.wufoo.com\/forms\/w19lp8m31l8mow5\/\">contact us<\/a>\n\t\t\t<\/div>\n<\/div>\n\n<\/aside>\n\n\n\n<p>It took years, a chain of <a href=\"https:\/\/kffhealthnews.org\/news\/article\/health-insurance-prior-authorization-coverage-infusions\/\">conflicting decisions<\/a>, and a health insurer switch before she finally won approval. She started treatment in January and now channels time and energy into helping other patients fight denials.<\/p>\n\n\n\n<p>\u201cOne of the things I tell people when they come to me is: \u2018Don\u2019t panic. This isn\u2019t a final no,\u2019\u201d said Nix, 55, of Statesville, North Carolina.<\/p>\n\n\n\n<p>To control costs, nearly all health insurers use a system called prior authorization, which requires patients or their providers to seek approval before they can get certain procedures, tests, and prescriptions.<\/p>\n\n\n\n<p>Denials can be appealed, but nearly half of insured adults who received a prior authorization denial in the past two years reported the appeals process was either somewhat or very difficult, according to <a href=\"https:\/\/www.kff.org\/patient-consumer-protections\/poll-finding\/kff-health-tracking-poll-public-finds-prior-authorization-process-difficult-to-manage\/\">a July poll published by KFF<\/a>, a health information nonprofit that includes KFF Health News.<\/p>\n\n\n\n<p>&#8220;It&#8217;s overwhelming by design,\u201d because insurers know confusion and fatigue cause people to give up, Nix said. \u201cThat\u2019s exactly what they want you to do.\u201d<\/p>\n\n\n\n<p>The good news is you don\u2019t have to be an insurance expert to get results, she said. \u201cYou just need to know how to push back.\u201d<\/p>\n\n\n\n<p>Here are tips to consider when faced with a prior authorization denial:<\/p>\n\n\n<div\n\tclass=\"wp-block block--newsletter  \"\n\tdata-type=\"kaiser-health-news\/newsletter\"\n\tdata-align=\"center\"\n\tstyle=\"\"\n>\n\t<h4 class=\"newsletter__title\">\n\t\t<a href=\"\/email\/\">\n\t\t\tEmail Sign-Up\t\t<\/a>\n\t<\/h4>\n\t<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#039; free weekly newsletter, &quot;The Week in Brief.&quot;\t<\/p>\n\t\n<form\n\taction=\"\/email-signup\/\"\n\tclass=\"kaiser-hubspot-mini-signup-form\"\n\tmethod=\"post\"\n>\n\t<input type=\"hidden\" id=\"kaiser_hubspot_nonce\" name=\"kaiser_hubspot_nonce\" value=\"87a489a56a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/article\/2078398\" \/>\t\t\t\t<label\n\t\tclass=\"kaiser-hubspot-mini-signup-form__label--email\"\n\t\tfor=\"kaiser-hubspot-mini-signup-form-email\"\n\t>\n\t\t<span class=\"screen-reader-text\">\n\t\t\tYour Email Address\t\t<\/span>\n\t\t<input\n\t\t\tautocomplete=\"email\"\n\t\t\tclass=\"kaiser-hubspot-mini-signup-form__input--email\"\n\t\t\tid=\"kaiser-hubspot-mini-signup-form-email\"\n\t\t\tname=\"kaiser_hubspot_email\"\n\t\t\ttype=\"email\"\n\t\t\t\t\t\t\tplaceholder=\"Your email address\"\n\t\t\t\t\t\/>\n\t<\/label>\n\t<button class=\"kaiser-hubspot-mini-signup-form__submit\">\n\t\tSign Up\t<\/button>\n<\/form>\n<\/div>\n\n\n\n<p style=\"font-size:25px\"><strong>1. Know your insurance plan.<\/strong><\/p>\n\n\n\n<p>Do you have insurance through your job? A plan purchased through healthcare.gov? Medicare? Medicare Advantage? Medicaid?<\/p>\n\n\n\n<p>These distinctions can be confusing, but they matter a great deal. Different categories of health insurance are governed by different agencies and are therefore subject to different prior authorization rules.<\/p>\n\n\n\n<p>For example, federal marketplace plans, as well as Medicare and Medicare Advantage plans, are regulated by the U.S. Department of Health and Human Services. Employer-sponsored plans are regulated by the Department of Labor. Medicaid plans, administered by state agencies, are subject to both state and federal rules.<\/p>\n\n\n\n<p>Learn the language specific to your policy. Health insurance companies do not apply prior authorization requirements uniformly across all plans. Read your policy closely to make sure your insurer is following its own rules, as well as regulations set by the state and federal government.<\/p>\n\n\n\n<p style=\"font-size:25px\"><strong>2. Work with your provider to appeal.<\/strong><\/p>\n\n\n\n<p>Kathleen Lavanchy, who retired in 2024 from a job at an inpatient rehabilitation hospital in the Philadelphia area, spent much of her career communicating with health insurance companies on behalf of patients.<\/p>\n\n\n\n<p>Before you contact your health insurer, call your provider, Lavanchy said, and ask to speak to a medical care manager or someone in the office who handles prior authorization appeals.<\/p>\n\n\n\n<p>The good news is that your doctor\u2019s office may already be working on an appeal.<\/p>\n\n\n\n<p>Medical staffers can act as \u201cyour voice,\u201d Nix said. \u201cThey know all the language.\u201d<\/p>\n\n\n\n<p>You or your provider can request a \u201cpeer-to-peer&#8221; review during the appeals process, which allows your doctor to discuss your case over the phone with a medical professional who works for the insurance company.<\/p>\n\n\n\n<p style=\"font-size:25px\"><strong>3. Be organized.<\/strong><\/p>\n\n\n\n<p>Many hospitals and doctors use a system called MyChart to organize medical records, test results, and communications so that they are easily accessible. Similarly, patients should keep track of all materials related to an insurance appeal \u2014 records of phone calls, emails, snail mail, and in-app messages.<\/p>\n\n\n\n<p>Everything should be organized, either digitally or on paper, so that it can be easily referenced, Nix said. At one point, she said, her own records proved that her insurance company had given conflicting information. The records were \u201cthe thing that saved me,\u201d she said.<\/p>\n\n\n\n<p>&#8220;Keep an amazing paper trail,\u201d she said. \u201cEvery call, every letter, every name.\u201d<\/p>\n\n\n\n<p>Linda Jorgensen, executive director of the Special Needs Resource Project, a nonprofit offering online resources for patients with disabilities and their families, has advised patients who are fighting a denial to specifically keep paper copies of everything.<\/p>\n\n\n\n<p>\u201cIf it isn\u2019t on paper, it didn\u2019t happen,\u201d she said.<\/p>\n\n\n\n<p>Jorgensen, who serves as a caregiver to an adult daughter with special needs, created <a href=\"http:\/\/www.snrproject.com\/downloads\/SNRP_FORM_CallForm.pdf\">a free form<\/a> you can print to help guide you when taking notes during phone calls with your insurance company. She advised asking the insurance representative for a \u201cticket number\u201d and their name before proceeding with the conversation.<\/p>\n\n\n\n<figure class=\"wp-block-image alignwide size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"3840\" height=\"2160\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg\" alt=\"\" class=\"wp-image-1775684\" srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg 3840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=150,84 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=500,281 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=768,432 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=1270,714 1270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=1536,864 1536w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=2048,1152 2048w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=120,68 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=170,96 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=300,169 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=315,177 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=630,354 630w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/2023-11-14_Prior_Auth_Whiplash-final.jpg?resize=1200,675 1200w\" sizes=\"auto, (max-width: 3840px) 100vw, 3840px\" \/><figcaption><span class=\"photo-credit\">(Oona Zenda\/KFF Health News)<\/span><\/figcaption><\/figure>\n\n\n\n<p style=\"font-size:25px\"><strong>4. Appeal as soon as possible.<\/strong><\/p>\n\n\n\n<p>The silver lining is that most denials, if appealed, are overturned.<\/p>\n\n\n\n<p>Medicare Advantage <a href=\"https:\/\/www.kff.org\/medicare\/issue-brief\/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023\/\">data published by KFF<\/a> in January found that nearly 82% of prior authorization denials from 2019 through 2023 were partially or fully overturned upon appeal.<\/p>\n\n\n\n<p>But the clock is ticking. Most health plans give you only six months to appeal the decision, according to <a href=\"https:\/\/www.healthcare.gov\/appeal-insurance-company-decision\/internal-appeals\/\">rules laid out<\/a> in the Affordable Care Act.<\/p>\n\n\n\n<p>\u201cDon\u2019t dillydally,\u201d Jorgensen advised, especially if you\u2019re sending a paper appeal, or any supporting documents, through the U.S. Postal Service. She recommends filing quickly, and at least four weeks before the deadline.<\/p>\n\n\n\n<p>For the sake of speed, some people are <a href=\"https:\/\/www.nbcnews.com\/news\/us-news\/ai-helping-patients-fight-insurance-company-denials-wild-rcna219008\">turning to artificial intelligence<\/a> for help crafting customizable appeal letters.<\/p>\n\n\n\n<p style=\"font-size:25px\"><strong>5. Ask your HR department for help.<\/strong><\/p>\n\n\n\n<p>If you get your health insurance through an employer, there&#8217;s a good chance your health plan is \u201cself-funded\u201d or \u201cself-insured.\u201d That means your employer contracts with a health insurance company to administer benefits, but your employer shoulders the cost of your care.<\/p>\n\n\n\n<p>Why does that matter? Under self-funded plans, decisions about what is or isn\u2019t covered ultimately rest with your employer.<\/p>\n\n\n\n<p>Let\u2019s say, for example, your doctor has recommended that you undergo surgery, and your insurer has denied prior authorization for it, deeming the procedure \u201cnot medically necessary,\u201d a phrase commonly used. If your plan is self-funded, you can appeal to the human resources department at your job, because your employer is on the hook for your health care costs \u2014 not the insurer.<\/p>\n\n\n\n<p>Of course, there&#8217;s no guarantee your employer will agree to pay. But, at the very least, it\u2019s worth reaching out for help.<\/p>\n\n\n\n<p style=\"font-size:25px\"><strong>6. Find an advocate.<\/strong><\/p>\n\n\n\n<p>Many states operate free <a href=\"https:\/\/www.cms.gov\/cciio\/resources\/consumer-assistance-grants\">consumer assistance programs<\/a>, available by phone or email, which can help you file an appeal. They can explain your benefits and may intervene if your insurance company isn\u2019t complying with requirements.<\/p>\n\n\n\n<p>Beyond that, some nonprofit advocacy groups, such as the Patient Advocate Foundation, might help. On the foundation\u2019s website is <a href=\"https:\/\/www.patientadvocate.org\/explore-our-resources\/insurance-denials-appeals\/things-to-include-in-your-appeal-letter\/\">guidance about what to include in an appeal letter<\/a>. For those battling severe disease, foundation staffers can work with you one-on-one to fight a denial.<\/p>\n\n\n\n<p style=\"font-size:25px\"><strong>7. Make noise.<\/strong><\/p>\n\n\n\n<p>We\u2019ve <a href=\"https:\/\/kffhealthnews.org\/news\/tag\/prior-authorizations\/\">written about this before<\/a>. Sometimes, when <a href=\"https:\/\/kffhealthnews.org\/news\/article\/doctors-patients-shame-insurers-online-prior-authorization-denials\/\">patients and doctors shame insurers online<\/a>, denials get overturned.<\/p>\n\n\n\n<div class=\"has-eyebrow is-style-classic  wp-block-kff-common-promo\">\n\t\t\t<div class=\"wp-block-kff-common-promo__image\">\n\t\t\t<a class=\"wp-block-kff-common-promo__link\" href=\"https:\/\/kffhealthnews.org\/news\/article\/doctors-patients-shame-insurers-online-prior-authorization-denials\/\">\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"333\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?w=500\" class=\"attachment-medium size-medium\" alt=\"A photo of a woman sitting next to a dog indoors.\" srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg 3840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=150,100 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=500,333 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=768,512 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=1270,847 1270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=1536,1024 1536w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=2048,1365 2048w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=770,513 770w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=840,560 840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=720,480 720w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=570,380 570w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=370,247 370w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=270,180 270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=170,113 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=100,67 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=120,80 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=1170,780 1170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=300,200 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=200,134 200w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=315,210 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=630,420 630w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/08\/Nix_04-resized.jpg?resize=1200,800 1200w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" \/>\t\t\t<\/a>\n\t\t<\/div>\n\t\t<div class=\"wp-block-kff-common-promo__inner\">\n\t\t\t\t\t<div class=\"wp-block-kff-common-promo__eyebrow\">related article<\/div>\n\t\t\t\t\t\t<h3 class=\"wp-block-kff-common-promo__title\">\n\t\t\t\t<a class=\"wp-block-kff-common-promo__link\" href=\"https:\/\/kffhealthnews.org\/news\/article\/doctors-patients-shame-insurers-online-prior-authorization-denials\/\">\n\t\t\t\t\tDoctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials\t\t\t\t<\/a>\n\t\t\t<\/h3>\n\t\t\t\t\t\t<a class=\"wp-block-kff-common-promo__read-more wp-block-kff-common-promo__link\" href=\"https:\/\/kffhealthnews.org\/news\/article\/doctors-patients-shame-insurers-online-prior-authorization-denials\/\">Read More<\/a>\n\t\t\t<\/div>\n<\/div>\n\n\n\n<p>The same holds when patients contact lawmakers. State laws regulate some categories of health insurance, and when it comes to setting policy, state lawmakers have the power to hold insurance companies accountable.<\/p>\n\n\n\n<p>Reaching out to your legislator isn\u2019t guaranteed to work, but it might be worth a shot.<\/p>\n\n\n\n<p>Finally, if you\u2019re interested in sharing your experiences with a journalist, <a href=\"https:\/\/kaiserfamilyfoundation.wufoo.com\/forms\/w19lp8m31l8mow5\/\">fill out this form<\/a>. We\u2019d like to hear from you.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Many people don\u2019t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.<\/p>\n","protected":false},"featured_media":2121992,"template":"","meta":{"_cr_original_post":"","_cr_replace_post_id":"","_cr_replacing_post_id":"","jetpack_post_was_ever_published":false,"kff_featured_video":0,"kff_show_featured_video":false,"kff_show_mute_audio_button":false,"custom_shortlink":"\/MjA3ODM5OA","kaiser_health_news_byline_override":"","kaiser_health_news_can_republish":true,"kaiser_health_news_featured_image_caption":"","kaiser_health_news_header_overlay_color":"","kaiser_health_news_header_theme_slug":"theme-title-overlay","kaiser_health_news_hero_image":0,"kaiser_health_news_backdrop_padding":115,"kaiser_health_news_hide_partner":false,"kaiser_health_news_kicker":"Deadly Denials","kaiser_health_news_kicker_background_color":"","kaiser_health_news_kicker_text_color":"","kaiser_health_news_kicker_url":"https:\/\/kffhealthnews.org\/news\/tag\/prior-authorizations\/","kaiser_health_news_nav_theme_slug":"compact","kaiser_health_news_nav_transparency":false,"kaiser_health_news_sharing_title":"","kaiser_health_news_show_featured_image":true,"kaiser_health_news_subheadline":"","kaiser_health_news_suppress_kicker":false,"kaiser_health_news_suppress_subheadline":false,"kaiser_health_news_update_time":"","kaiser_health_news_vertical_image":0,"kaiser_health_news_title_align_left":false,"kaiser_health_news_custom_header_image":0,"photo_byline":[],"story_update":"","update_position":"bottom","kaiser_syndication_sites":[],"apple_news_api_created_at":"2025-09-04T09:08:34Z","apple_news_api_id":"32997292-cdca-4d70-9f83-d4462d74159c","apple_news_api_modified_at":"2025-11-20T20:11:31Z","apple_news_api_revision":"AAAAAAAAAAAAAAAAAAAACw==","apple_news_api_share_url":"https:\/\/apple.news\/AMplyks3KTXCfg9RGLXQVnA","apple_news_cover_media_provider":"image","apple_news_coverimage":0,"apple_news_coverimage_caption":"","apple_news_cover_video_id":0,"apple_news_cover_video_url":"","apple_news_cover_embedwebvideo_url":"","apple_news_is_hidden":"","apple_news_is_paid":"","apple_news_is_preview":"","apple_news_is_sponsored":"","apple_news_maturity_rating":"","apple_news_metadata":"\"\"","apple_news_pullquote":"","apple_news_pullquote_position":"","apple_news_slug":"","apple_news_sections":["https:\/\/news-api.apple.com\/sections\/20265c01-23d7-4d15-96e0-0691b89c3772"],"apple_news_suppress_video_url":false,"apple_news_use_image_component":false,"_ef_editorial_meta_date_first-draft-date":"","_ef_editorial_meta_paragraph_assignment":"","_ef_editorial_meta_checkbox_needs-photo":"","_ef_editorial_meta_user_copyeditor":"","_ef_editorial_meta_paragraph_tweets":"","_ef_editorial_meta_text_partner-pitch":"","_ef_editorial_meta_date_estimated-pub-date":"","footnotes":""},"categories":[439524256,178379,12498,439528530,36835],"tags":[439529530,20037],"primary-topic":[],"partners":[439524323],"funder":[439528750],"coauthors":[439528979],"class_list":["post-2078398","article","type-article","status-publish","has-post-thumbnail","hentry","category-health-care-costs","category-health-industry","category-insurance","category-southern-bureau","category-syndicate","tag-prior-authorizations","tag-north-carolina","partners-nbc-news","funder-robert-wood-johnson-foundation"],"apple_news_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Fighting a Health Insurance Denial? 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