ABA Therapy Denied by Insurance? How to Appeal
Insurance denied or cut ABA therapy hours for autism? State mandates, mental health parity, treatment plan tips, and how to appeal an ABA denial.
·5 min read
Insurance Appeal Guides
AppealFlow editorial publishes free guides on US health insurance denials, appeal deadlines, payer processes, and medical billing disputes. Each article explains your rights under ERISA, ACA, or Medicare rules where they apply and links to a matching free appeal generator when one exists.
Health insurance denials arrive with jargon: medical necessity edits, prior authorization failures, step therapy requirements, and remark codes on your remittance advice. Our guides translate those terms into plain steps you can take before an appeal deadline passes. We focus on US health coverage only, not auto, home, or life insurance.
Every guide is written by AppealFlow editorial and reviewed against primary sources such as Healthcare.gov appeal rules, ERISA claims procedure regulations, and Medicare.gov when Medicare topics apply. When a specialized generator fits your denial type, the article points you to the matching tool so you can draft a letter faster.
New articles cover GLP-1 and weight-loss medication appeals, MRI and imaging denials, dental and orthodontic claims, surprise emergency bills under the No Surprises Act, and general workflows like internal appeal versus external review. Use the list below to find a guide that matches your denial reason code or benefit issue.
How Do I Find a Guide for My Denial Type?
Start with the denial reason on your EOB or adverse benefit determination letter. Search the article list for your drug name, procedure, or code (for example CO-50 medical necessity or a prior authorization denial). Denial code pages at /denial-codes explain common CARC codes and link to longer how-to guides.
Which Tools Match These Guides?
The free appeal generator handles general claim denials. The tools hub lists specialized generators for GLP-1 medications, MRI denials, prior authorization, prescription formulary exceptions, dental claims, and No Surprises Act disputes. Pick the tool that matches the article you read.
What If My Appeal Deadline Is Soon?
Check your EOB for the internal appeal deadline first. ERISA employer plans often allow at least 180 days for a first-level appeal, while ACA marketplace notices may use shorter windows. File before the printed date even if you are still collecting records; many plans let you supplement the file after the initial submission.
173 articles · Newest first
Bariatric Surgery Denied? How to Appeal Weight-Loss Surgery
Weight-loss surgery denied by insurance? BMI criteria, supervised diet requirements, psych evaluations, plan exclusions, and how to appeal a bariatric denial.
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Biologic Drug Denied? How to Appeal Humira, Dupixent & More
Insurer denied a biologic like Humira, Dupixent, Stelara or Skyrizi? Prior authorization criteria, biosimilar switches, step therapy and how to appeal.
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Breast Reduction Denied by Insurance? How to Appeal
Insurance denied breast reduction as cosmetic? What criteria plans use (symptoms, conservative care, tissue removed) and how to build a medical necessity appeal.
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Cancer Treatment Denied by Insurance? How to Appeal
Insurance denied chemotherapy, radiation, a cancer drug or clinical trial costs? Guidelines insurers use, off-label rules, expedited appeals, and your rights.
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Claim Denied for Missing Information? How to Fix It
Insurance claim denied for missing or incomplete information? What the plan is asking for, corrected claims vs appeals, deadlines, and how to resolve it.
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Coordination of Benefits Denial: How to Fix It Fast
Claim denied for coordination of benefits? Learn why insurers ask about other coverage, the birthday rule, Medicare secondary rules and how to clear it.
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CPAP Denied by Insurance? Compliance Rules and Appeals
CPAP coverage denied for low usage or missing paperwork? The 4-hour, 70% compliance rule, the 31 to 91 day re-evaluation, and how to appeal a CPAP denial.
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Durable Medical Equipment Denied? How to Appeal DME
Wheelchair, hospital bed, walker or oxygen denied by insurance? Common DME denial reasons, Medicare rules, and how to appeal with the right documentation.
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ER Claim Denied? The Prudent Layperson Rule Explained
Insurance denied your emergency room visit as non-emergency? How the ACA prudent layperson standard works, No Surprises Act protections, and how to appeal.
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Genetic Testing Denied by Insurance? How to Appeal
Insurer denied BRCA, hereditary cancer, or other genetic testing? Common reasons, the guidelines plans use, ACA preventive rules, and how to build an appeal.
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Health Insurance Rescinded? Your Rights and How to Appeal
Insurer cancelled your coverage retroactively? When rescission is allowed under the ACA, the 30-day notice rule, and how to appeal a rescission.
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