Skip to main content
Apellica
Start
Appeal guides

Find your exact appeal guide.

Choose your carrier and your denial reason to get the step-by-step playbook with the controlling regulation, the specific plan-language requirement, and the clinical standard that controls reversal.

UnitedHealthcare appeal guides

Carrier overview →
Surgery denials
UHC × Surgery
Open guide →
MRI and imaging denials
UHC × MRI and imaging
Open guide →
Medication and prescription denials
UHC × Medication and prescription
Open guide →
Medicare denials
UHC × Medicare
Open guide →
Prior authorization denials
UHC × Prior authorization
Open guide →
Experimental or investigational denials
UHC × Experimental or investigational
Open guide →
Mental health parity denials
UHC × Mental health parity
Open guide →
Out-of-network emergency denials
UHC × Out-of-network emergency
Open guide →
Infertility and IVF denials
UHC × Infertility and IVF
Open guide →
Gender-affirming care denials
UHC × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
UHC × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
UHC × Residential and level-of-care
Open guide →
Air ambulance balance billing
UHC × Air ambulance balance billing
Open guide →
Step therapy override denials
UHC × Step therapy override
Open guide →
Inpatient rehabilitation denials
UHC × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
UHC × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
UHC × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
UHC × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
UHC × Biologic and infusion therapy
Open guide →
Physical therapy denials
UHC × Physical therapy
Open guide →
ABA therapy denials
UHC × ABA therapy
Open guide →
Bariatric surgery denials
UHC × Bariatric surgery
Open guide →
Breast reconstruction denials
UHC × Breast reconstruction
Open guide →
CPAP and medical equipment denials
UHC × CPAP and medical equipment
Open guide →

Aetna (CVS Health) appeal guides

Carrier overview →
Surgery denials
Aetna × Surgery
Open guide →
MRI and imaging denials
Aetna × MRI and imaging
Open guide →
Medication and prescription denials
Aetna × Medication and prescription
Open guide →
Medicare denials
Aetna × Medicare
Open guide →
Prior authorization denials
Aetna × Prior authorization
Open guide →
Experimental or investigational denials
Aetna × Experimental or investigational
Open guide →
Mental health parity denials
Aetna × Mental health parity
Open guide →
Out-of-network emergency denials
Aetna × Out-of-network emergency
Open guide →
Infertility and IVF denials
Aetna × Infertility and IVF
Open guide →
Gender-affirming care denials
Aetna × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Aetna × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Aetna × Residential and level-of-care
Open guide →
Air ambulance balance billing
Aetna × Air ambulance balance billing
Open guide →
Step therapy override denials
Aetna × Step therapy override
Open guide →
Inpatient rehabilitation denials
Aetna × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Aetna × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Aetna × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Aetna × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Aetna × Biologic and infusion therapy
Open guide →
Physical therapy denials
Aetna × Physical therapy
Open guide →
ABA therapy denials
Aetna × ABA therapy
Open guide →
Bariatric surgery denials
Aetna × Bariatric surgery
Open guide →
Breast reconstruction denials
Aetna × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Aetna × CPAP and medical equipment
Open guide →

Cigna (Evernorth) appeal guides

Carrier overview →
Surgery denials
Cigna × Surgery
Open guide →
MRI and imaging denials
Cigna × MRI and imaging
Open guide →
Medication and prescription denials
Cigna × Medication and prescription
Open guide →
Medicare denials
Cigna × Medicare
Open guide →
Prior authorization denials
Cigna × Prior authorization
Open guide →
Experimental or investigational denials
Cigna × Experimental or investigational
Open guide →
Mental health parity denials
Cigna × Mental health parity
Open guide →
Out-of-network emergency denials
Cigna × Out-of-network emergency
Open guide →
Infertility and IVF denials
Cigna × Infertility and IVF
Open guide →
Gender-affirming care denials
Cigna × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Cigna × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Cigna × Residential and level-of-care
Open guide →
Air ambulance balance billing
Cigna × Air ambulance balance billing
Open guide →
Step therapy override denials
Cigna × Step therapy override
Open guide →
Inpatient rehabilitation denials
Cigna × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Cigna × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Cigna × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Cigna × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Cigna × Biologic and infusion therapy
Open guide →
Physical therapy denials
Cigna × Physical therapy
Open guide →
ABA therapy denials
Cigna × ABA therapy
Open guide →
Bariatric surgery denials
Cigna × Bariatric surgery
Open guide →
Breast reconstruction denials
Cigna × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Cigna × CPAP and medical equipment
Open guide →

Anthem / BlueCross BlueShield appeal guides

Carrier overview →
Surgery denials
BCBS × Surgery
Open guide →
MRI and imaging denials
BCBS × MRI and imaging
Open guide →
Medication and prescription denials
BCBS × Medication and prescription
Open guide →
Medicare denials
BCBS × Medicare
Open guide →
Prior authorization denials
BCBS × Prior authorization
Open guide →
Experimental or investigational denials
BCBS × Experimental or investigational
Open guide →
Mental health parity denials
BCBS × Mental health parity
Open guide →
Out-of-network emergency denials
BCBS × Out-of-network emergency
Open guide →
Infertility and IVF denials
BCBS × Infertility and IVF
Open guide →
Gender-affirming care denials
BCBS × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
BCBS × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
BCBS × Residential and level-of-care
Open guide →
Air ambulance balance billing
BCBS × Air ambulance balance billing
Open guide →
Step therapy override denials
BCBS × Step therapy override
Open guide →
Inpatient rehabilitation denials
BCBS × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
BCBS × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
BCBS × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
BCBS × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
BCBS × Biologic and infusion therapy
Open guide →
Physical therapy denials
BCBS × Physical therapy
Open guide →
ABA therapy denials
BCBS × ABA therapy
Open guide →
Bariatric surgery denials
BCBS × Bariatric surgery
Open guide →
Breast reconstruction denials
BCBS × Breast reconstruction
Open guide →
CPAP and medical equipment denials
BCBS × CPAP and medical equipment
Open guide →

Humana appeal guides

Carrier overview →
Surgery denials
Humana × Surgery
Open guide →
MRI and imaging denials
Humana × MRI and imaging
Open guide →
Medication and prescription denials
Humana × Medication and prescription
Open guide →
Medicare denials
Humana × Medicare
Open guide →
Prior authorization denials
Humana × Prior authorization
Open guide →
Experimental or investigational denials
Humana × Experimental or investigational
Open guide →
Mental health parity denials
Humana × Mental health parity
Open guide →
Out-of-network emergency denials
Humana × Out-of-network emergency
Open guide →
Infertility and IVF denials
Humana × Infertility and IVF
Open guide →
Gender-affirming care denials
Humana × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Humana × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Humana × Residential and level-of-care
Open guide →
Air ambulance balance billing
Humana × Air ambulance balance billing
Open guide →
Step therapy override denials
Humana × Step therapy override
Open guide →
Inpatient rehabilitation denials
Humana × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Humana × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Humana × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Humana × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Humana × Biologic and infusion therapy
Open guide →
Physical therapy denials
Humana × Physical therapy
Open guide →
ABA therapy denials
Humana × ABA therapy
Open guide →
Bariatric surgery denials
Humana × Bariatric surgery
Open guide →
Breast reconstruction denials
Humana × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Humana × CPAP and medical equipment
Open guide →

Medicare (Original + Advantage) appeal guides

Carrier overview →
Surgery denials
Medicare × Surgery
Open guide →
MRI and imaging denials
Medicare × MRI and imaging
Open guide →
Medication and prescription denials
Medicare × Medication and prescription
Open guide →
Prior authorization denials
Medicare × Prior authorization
Open guide →
Experimental or investigational denials
Medicare × Experimental or investigational
Open guide →
Mental health parity denials
Medicare × Mental health parity
Open guide →
Out-of-network emergency denials
Medicare × Out-of-network emergency
Open guide →
Infertility and IVF denials
Medicare × Infertility and IVF
Open guide →
Gender-affirming care denials
Medicare × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Medicare × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Medicare × Residential and level-of-care
Open guide →
Air ambulance balance billing
Medicare × Air ambulance balance billing
Open guide →
Step therapy override denials
Medicare × Step therapy override
Open guide →
Inpatient rehabilitation denials
Medicare × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Medicare × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Medicare × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Medicare × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Medicare × Biologic and infusion therapy
Open guide →
Physical therapy denials
Medicare × Physical therapy
Open guide →
Bariatric surgery denials
Medicare × Bariatric surgery
Open guide →
Breast reconstruction denials
Medicare × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Medicare × CPAP and medical equipment
Open guide →

Kaiser Permanente appeal guides

Carrier overview →
Surgery denials
Kaiser × Surgery
Open guide →
MRI and imaging denials
Kaiser × MRI and imaging
Open guide →
Medication and prescription denials
Kaiser × Medication and prescription
Open guide →
Medicare denials
Kaiser × Medicare
Open guide →
Prior authorization denials
Kaiser × Prior authorization
Open guide →
Experimental or investigational denials
Kaiser × Experimental or investigational
Open guide →
Mental health parity denials
Kaiser × Mental health parity
Open guide →
Out-of-network emergency denials
Kaiser × Out-of-network emergency
Open guide →
Infertility and IVF denials
Kaiser × Infertility and IVF
Open guide →
Gender-affirming care denials
Kaiser × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Kaiser × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Kaiser × Residential and level-of-care
Open guide →
Air ambulance balance billing
Kaiser × Air ambulance balance billing
Open guide →
Step therapy override denials
Kaiser × Step therapy override
Open guide →
Inpatient rehabilitation denials
Kaiser × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Kaiser × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Kaiser × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Kaiser × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Kaiser × Biologic and infusion therapy
Open guide →
Physical therapy denials
Kaiser × Physical therapy
Open guide →
ABA therapy denials
Kaiser × ABA therapy
Open guide →
Bariatric surgery denials
Kaiser × Bariatric surgery
Open guide →
Breast reconstruction denials
Kaiser × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Kaiser × CPAP and medical equipment
Open guide →

Centene / Ambetter appeal guides

Carrier overview →
Surgery denials
Ambetter × Surgery
Open guide →
MRI and imaging denials
Ambetter × MRI and imaging
Open guide →
Medication and prescription denials
Ambetter × Medication and prescription
Open guide →
Medicare denials
Ambetter × Medicare
Open guide →
Prior authorization denials
Ambetter × Prior authorization
Open guide →
Experimental or investigational denials
Ambetter × Experimental or investigational
Open guide →
Mental health parity denials
Ambetter × Mental health parity
Open guide →
Out-of-network emergency denials
Ambetter × Out-of-network emergency
Open guide →
Infertility and IVF denials
Ambetter × Infertility and IVF
Open guide →
Gender-affirming care denials
Ambetter × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Ambetter × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Ambetter × Residential and level-of-care
Open guide →
Air ambulance balance billing
Ambetter × Air ambulance balance billing
Open guide →
Step therapy override denials
Ambetter × Step therapy override
Open guide →
Inpatient rehabilitation denials
Ambetter × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Ambetter × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Ambetter × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Ambetter × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Ambetter × Biologic and infusion therapy
Open guide →
Physical therapy denials
Ambetter × Physical therapy
Open guide →
ABA therapy denials
Ambetter × ABA therapy
Open guide →
Bariatric surgery denials
Ambetter × Bariatric surgery
Open guide →
Breast reconstruction denials
Ambetter × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Ambetter × CPAP and medical equipment
Open guide →

Molina Healthcare appeal guides

Carrier overview →
Surgery denials
Molina × Surgery
Open guide →
MRI and imaging denials
Molina × MRI and imaging
Open guide →
Medication and prescription denials
Molina × Medication and prescription
Open guide →
Medicare denials
Molina × Medicare
Open guide →
Prior authorization denials
Molina × Prior authorization
Open guide →
Experimental or investigational denials
Molina × Experimental or investigational
Open guide →
Mental health parity denials
Molina × Mental health parity
Open guide →
Out-of-network emergency denials
Molina × Out-of-network emergency
Open guide →
Infertility and IVF denials
Molina × Infertility and IVF
Open guide →
Gender-affirming care denials
Molina × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
Molina × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
Molina × Residential and level-of-care
Open guide →
Air ambulance balance billing
Molina × Air ambulance balance billing
Open guide →
Step therapy override denials
Molina × Step therapy override
Open guide →
Inpatient rehabilitation denials
Molina × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
Molina × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
Molina × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
Molina × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
Molina × Biologic and infusion therapy
Open guide →
Physical therapy denials
Molina × Physical therapy
Open guide →
ABA therapy denials
Molina × ABA therapy
Open guide →
Bariatric surgery denials
Molina × Bariatric surgery
Open guide →
Breast reconstruction denials
Molina × Breast reconstruction
Open guide →
CPAP and medical equipment denials
Molina × CPAP and medical equipment
Open guide →

BCBS Federal Employee Program (FEP) appeal guides

Carrier overview →
Surgery denials
BCBS FEP × Surgery
Open guide →
MRI and imaging denials
BCBS FEP × MRI and imaging
Open guide →
Medication and prescription denials
BCBS FEP × Medication and prescription
Open guide →
Medicare denials
BCBS FEP × Medicare
Open guide →
Prior authorization denials
BCBS FEP × Prior authorization
Open guide →
Experimental or investigational denials
BCBS FEP × Experimental or investigational
Open guide →
Mental health parity denials
BCBS FEP × Mental health parity
Open guide →
Out-of-network emergency denials
BCBS FEP × Out-of-network emergency
Open guide →
Infertility and IVF denials
BCBS FEP × Infertility and IVF
Open guide →
Gender-affirming care denials
BCBS FEP × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
BCBS FEP × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
BCBS FEP × Residential and level-of-care
Open guide →
Air ambulance balance billing
BCBS FEP × Air ambulance balance billing
Open guide →
Step therapy override denials
BCBS FEP × Step therapy override
Open guide →
Inpatient rehabilitation denials
BCBS FEP × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
BCBS FEP × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
BCBS FEP × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
BCBS FEP × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
BCBS FEP × Biologic and infusion therapy
Open guide →
Physical therapy denials
BCBS FEP × Physical therapy
Open guide →
ABA therapy denials
BCBS FEP × ABA therapy
Open guide →
Bariatric surgery denials
BCBS FEP × Bariatric surgery
Open guide →
Breast reconstruction denials
BCBS FEP × Breast reconstruction
Open guide →
CPAP and medical equipment denials
BCBS FEP × CPAP and medical equipment
Open guide →

TRICARE appeal guides

Carrier overview →
Surgery denials
TRICARE × Surgery
Open guide →
MRI and imaging denials
TRICARE × MRI and imaging
Open guide →
Medication and prescription denials
TRICARE × Medication and prescription
Open guide →
Medicare denials
TRICARE × Medicare
Open guide →
Prior authorization denials
TRICARE × Prior authorization
Open guide →
Experimental or investigational denials
TRICARE × Experimental or investigational
Open guide →
Mental health parity denials
TRICARE × Mental health parity
Open guide →
Out-of-network emergency denials
TRICARE × Out-of-network emergency
Open guide →
Infertility and IVF denials
TRICARE × Infertility and IVF
Open guide →
Gender-affirming care denials
TRICARE × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
TRICARE × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
TRICARE × Residential and level-of-care
Open guide →
Air ambulance balance billing
TRICARE × Air ambulance balance billing
Open guide →
Step therapy override denials
TRICARE × Step therapy override
Open guide →

WellCare (Centene) appeal guides

Carrier overview →
Surgery denials
WellCare × Surgery
Open guide →
MRI and imaging denials
WellCare × MRI and imaging
Open guide →
Medication and prescription denials
WellCare × Medication and prescription
Open guide →
Medicare denials
WellCare × Medicare
Open guide →
Prior authorization denials
WellCare × Prior authorization
Open guide →
Experimental or investigational denials
WellCare × Experimental or investigational
Open guide →
Mental health parity denials
WellCare × Mental health parity
Open guide →
Out-of-network emergency denials
WellCare × Out-of-network emergency
Open guide →
Infertility and IVF denials
WellCare × Infertility and IVF
Open guide →
Gender-affirming care denials
WellCare × Gender-affirming care
Open guide →
Transplant and immunosuppressant denials
WellCare × Transplant and immunosuppressant
Open guide →
Residential and level-of-care denials
WellCare × Residential and level-of-care
Open guide →
Air ambulance balance billing
WellCare × Air ambulance balance billing
Open guide →
Step therapy override denials
WellCare × Step therapy override
Open guide →
Inpatient rehabilitation denials
WellCare × Inpatient rehabilitation
Open guide →
Skilled nursing facility denials
WellCare × Skilled nursing facility
Open guide →
Inpatient hospital stay denials
WellCare × Inpatient hospital stay
Open guide →
IVIG and immunoglobulin denials
WellCare × IVIG and immunoglobulin
Open guide →
Biologic and infusion therapy denials
WellCare × Biologic and infusion therapy
Open guide →
Physical therapy denials
WellCare × Physical therapy
Open guide →
ABA therapy denials
WellCare × ABA therapy
Open guide →
Bariatric surgery denials
WellCare × Bariatric surgery
Open guide →
Breast reconstruction denials
WellCare × Breast reconstruction
Open guide →
CPAP and medical equipment denials
WellCare × CPAP and medical equipment
Open guide →

Don't see your carrier or denial type?

Submit a free intake at /start and a senior appeal reviewer will respond within one business day. We file appeals across all U.S. carriers and all standard denial categories.

Start my appealCall