Field notes
What we've learned navigating denials.
Tactics, denial-code playbooks, and the patterns we see across 50+ carriers. Honest, specific, no fluff.
Press releases
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Apr 28, 2026 · 6 min
Why fewer than 1% of denied claims are ever appealed
The system runs on the bet that you'll give up. Here's how that bet got built, and why it works on almost everyone.
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Drug coverage
Apr 21, 2026 · 7 min
GLP-1 denials (Wegovy, Ozempic, Zepbound): what actually flips them
BMI thresholds, T2D pathways, formulary exceptions. The three angles that win most GLP-1 appeals, and the one that wins them faster.
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Medicare
Apr 14, 2026 · 8 min
Medicare Advantage has five appeal levels. Most people stop at one.
Most people stop at Level 1. Level 2 (Maximus) and Level 3 (ALJ) are where the rest of the wins happen. Here's the full ladder.
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How to
Apr 7, 2026 · 5 min
What a winning appeal letter actually contains
Appeals aren't pleas. They're rebuttals. Five things every winning letter has, and the one phrase that does most of the work.
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Prior auth
Mar 31, 2026 · 5 min
Prior authorization: the denial that isn't really a denial
Most 'denials' are actually prior-auth refusals, and there's a separate, faster path to reverse them. Most patients don't know it exists.
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