The same dispute muscle — now aimed at your insurer

Your insurance denied a claim.
You have the right to appeal it.

Tell us what was denied and why. We write a professional, legally-grounded appeal letter personalized to your situation, citing PPACA Section 2719, ERISA §503, and the relevant medical-necessity standards. You print it, sign it, and mail it. $50, once. No subscription.

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Ready in 60 seconds Ready to print & mail Emailed to you instantly No subscription, ever
50–60% internal appeals succeed
4-month appeal window
Medical-necessity denials reversed at high rates

Most plans give you a 180-day appeal window — dental and Medicare Advantage have shorter deadlines. Don't wait.

Free Guide

Not ready to pay $50?

Get our free guide: 5 Steps to Win Your Insurance Appeal — includes the appeal-letter template, deadlines by plan type, and the external-review checklist. Delivered instantly.

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How it works

Three steps. No lawyers. No waiting.

Step 1

Describe the denial

Tell us your insurer, the denied claim, the denial reason on your EOB, and your medical situation. Takes about 2 minutes.

Step 2

Pay $50 securely

One-time payment via Stripe. No account required. Takes 30 seconds.

Step 3

Send your appeal

Your letter appears on screen instantly and lands in your inbox with the EOB citation and the HHS external-review instruction. Print it, sign it, send it.

Built on federal and state appeal rights, not guesswork

Your letter cites real laws and regulations that insurers are required to follow.

ACA internal/external appeal rights
PPACA Section 2719 — 180-day window, binding external review by an IRO
ERISA §503 for employer plans
Full and fair review rights for self-funded plans — written, reasoned decisions
NAIC Model Act cited
State insurance commissioner complaint pathway when appeals fail
No Surprises Act for emergency denials
Protects patients from out-of-network surprise ED and air-ambulance bills

See what your appeal letter looks like

We personalize it to your denial. Here's a redacted example.

Sample appeal letter — redacted for preview

Your full letter will include your name, address, insurer details, claim number, and your specific medical situation.

[Your Name]

[Your Address]

[City, ST ZIP]

[Date]

Appeals and Grievances Department

[Insurance Company Name]

[Insurance Address]

RE: Formal Internal Appeal — Claim #XXXXX — Member ID #XXXXX

To the Appeals Committee:

I am writing to formally appeal the denial of coverage dated [DENIAL DATE] for the [DENIED SERVICE] provided to me by [PROVIDER] on [DATE OF SERVICE]. After reviewing the denial notice citing "[DENIAL REASON]", I respectfully request that you reverse this decision on the following grounds…

Under PPACA Section 2719, I am entitled to a full and fair internal appeal of any adverse benefit determination. The cited medical-necessity criteria do not apply to my case. Per peer-reviewed clinical guidelines, the service in question is the standard of care for my diagnosis. I am formally requesting that a peer-to-peer review occur between my treating physician and your medical director.

I demand a written reversal of the denial, full coverage of the denied service, and a written response within 30 days of this letter. If the internal appeal is denied, I will immediately pursue external independent review through an HHS-approved IRO, and I will file a formal complaint with my state insurance commissioner. For emergency-service denials, the No Surprises Act (2022) also applies.

Sincerely,

[Your Name]

Your letter will be personalized with your denial reason, applicable law, and HHS external-review path
Get My Personalized Appeal Letter →
What our customers say

"My insurer denied my MRI saying it wasn't medically necessary. I had a documented neurological condition. BillFight cited the right guidelines and demanded a peer-to-peer review — the denial was reversed in 11 days."

— Rachel M., Seattle, WA

"ER visit at an in-network hospital, out-of-network radiologist billed $1,950. BillFight wrote a denial appeal citing the No Surprises Act — the charge was zeroed out within three weeks."

— Daniel P., Atlanta, GA

"My employer's self-funded plan denied my daughter's physical therapy as not medically necessary. BillFight's letter cited the right clinical guidelines and ERISA §503 — the plan reversed the denial within 30 days."

— Priya S., Denver, CO

Simple, honest pricing

One appeal letter. One price. Generated in 60 seconds.

$50
one-time  ·  no subscription  ·  no hidden fees
  • Personalized appeal letter, generated in 60 seconds
  • Cites PPACA §2719, ERISA §503, and relevant clinical guidelines
  • Sets a firm 30-day response deadline
  • Includes HHS external-review escalation path
  • Emailed to you immediately
  • A healthcare attorney costs $400+/hr. You pay $50.
Start My Appeal Letter — $50

BillFight provides document preparation assistance, not legal advice.

Frequently asked questions

Under the Affordable Care Act (PPACA Section 2719), most insured patients have 180 days from the date of the denial notice to file an internal appeal. Medicare Advantage enrollees have 60 days. After internal appeal is exhausted, you generally have 4 months to request an external independent review. Deadlines are strict — missing them forfeits your right to appeal.
An internal appeal asks your insurer to re-review its own denial — first step. An external review asks an independent review organization (IRO) — not affiliated with your insurer — to evaluate your case. Under ACA rules, internal appeals must be decided within 30 days for pre-service claims, 60 days for post-service claims, and 72 hours for urgent cases. The IRO's decision on external review is binding on the insurer. Most denials are reversed at the internal stage; nearly half of those that move to external review are reversed there.
No. BillFight provides document preparation — a structured, legally-informed appeal letter tailored to your denial. It is not legal advice and does not create an attorney-client relationship. For litigation or very high-dollar claims, consult a healthcare attorney. For the typical denial, a well-cited written appeal is sufficient — formal representation is rarely required.
Self-funded employer plans are governed by ERISA (Employee Retirement Income Security Act). ERISA §503 gives you the right to a full and fair review of any claim denial, with access to all documents and evidence the plan relied on and a written decision citing specific reasons. Your appeal must be filed within the plan's window (typically 60–180 days). After ERISA internal appeal is exhausted, you do not have a federal right to external review, but you may file suit in federal court under ERISA §502(a) or pursue state insurance commissioner complaint.
Yes — and prior-authorization denials are some of the most commonly reversed. If you're already receiving ongoing treatment, you can request an expedited appeal decided within 72 hours. Our appeal letters specifically address the medical-necessity criteria the insurer cited, demand a peer-to-peer review between your treating physician and the insurer's medical director, and cite peer-reviewed clinical guidelines for your diagnosis.
A dispute letter challenges the accuracy of a charge from a provider (overcharges, duplicate line items, upcoding). An appeal letter challenges a coverage decision from your insurer (claim denial, prior-authorization, medical-necessity denial). Both are formal written demands with deadlines and escalation paths — but the cited laws differ. BillFight ships both: the same professional dispute muscle applied to your insurer instead of your provider.
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