Reviewed by Main AI · Updated July 2026
Common reasons include missing information, a coverage exclusion, or a filing error — and most denials can be appealed. Request the written denial reason first, then respond to that specific reason.
The law: If your coverage is an employer group health plan, the plan must give you at least 180 days after you receive a denial notice to file an appeal — 29 CFR 2560.503-1(h)(3)(i).
Insurance claim denials are frequently reversible. Insurers generally have to give you the specific reason in writing, and many denials come down to fixable issues: a missing document, a coding error, a service they claim isn’t covered, or a deadline. Once you know the exact reason, you can appeal with targeted evidence. Internal appeals are your first step, and for health insurance you can often get an external review by an independent party if the internal appeal fails.
Deadlines vary by policy and state; employer group health plans must give you at least 180 days to appeal. Check your denial letter for the exact window.
Often yes — after exhausting internal appeals, many plans offer an external review by an independent organization, and its decision is often binding on the plan.
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