Question 1

Is there really no upfront payment to start?

Accepted Answer

Yes. Anyone with a denied claim is welcome to submit. There is no card required and no upfront cost to begin. A senior reviewer reads your file and walks you through the next steps. If your situation needs a different path, we will tell you clearly and walk through the alternatives.

Question 2

How fast will I hear back?

Accepted Answer

A senior reviewer reads your denial letter within 24 hours of receiving it and you get a written first assessment by email: whether the denial can be appealed, on what grounds, and what we still need from you. If your deadline is inside 7 days, tell us on the form or call +1 (888) 777 6120 and we start the same day.

Question 3

What if my deadline is tomorrow?

Accepted Answer

Call us at +1 (888) 777 6120 or write "deadline" in the subject when you reply to our confirmation email, and we look at it the same day. We will tell you straight whether a complete appeal can go out in time. If it cannot, we will tell you what you can send the carrier yourself today to protect the deadline, and we can strengthen it afterwards. Until Apellica accepts your case in writing, you remain responsible for tracking your own deadline.

Question 4

How does the contingency fee work?

Accepted Answer

One fee. Ten percent of whatever the carrier pays as a result of the appeal. Nothing if the appeal does not recover money. No setup fees, no monthly fees, no consultation bills, no per-document charges, and no cap. The engagement letter you sign before any work begins states this in writing.

Question 5

Do I pay anything if you lose?

Accepted Answer

No. If the carrier does not reverse the denial or pay anything as a result of the appeal, the fee is $0. You owe nothing for the reading, the assessment, the drafting or the filing. We close the file and return your documents on request.

Question 6

How is 10% charged on a $60,000 claim?

Accepted Answer

The fee is 10% of what the carrier actually pays because of the appeal, not 10% of what was billed. If the carrier pays the full $60,000, the fee is $6,000 and you keep $54,000. If the carrier pays $20,000 of it, the fee is $2,000. If the carrier pays nothing, the fee is $0. There is no cap, so the percentage is the same on a $600 claim and a $60,000 claim. We invoice only after the carrier's payment is confirmed and has reached you, with the carrier's written decision attached.

Question 7

Is this legal advice? Are you a law firm?

Accepted Answer

No. Apellica is not a law firm and does not provide legal or medical advice. We are an insurance appeal support service: we help you organize, prepare and submit appeals through the administrative process every insurer is required by law to provide. If your case needs a lawyer, for example a lawsuit under ERISA after the appeals are exhausted, we will tell you and point you to one.

Question 8

Do you take Medicare, Medicaid and employer plans?

Accepted Answer

Yes. We handle denials under Medicare Advantage, Original Medicare, Medicaid managed care, employer plans including self-funded ERISA plans, and ACA marketplace plans. Typical denials: medical necessity, prior authorization, formulary and step therapy, out-of-network, experimental or investigational, and timely filing. We do not take oncology or rare-disease claims at this time; for those we point you to your state's external review program and the Patient Advocate Foundation.

Question 9

What does Apellica actually do?

Accepted Answer

We read your denial letter, identify the strongest legal and clinical levers for that denial type and carrier, draft the appeal with real regulatory citations and your plan's own language, run it through automated quality checks and a senior reviewer, and file it through the carrier's appeals channel. You can do this yourself, the right to appeal is yours by law, but we do it faster and with stronger arguments, and you do not pay unless money is recovered.

Question 10

Who reads my medical records?

Accepted Answer

The senior reviewer and case team working on your file, and nobody else. Your records reach us only after you authorize it. Documents are encrypted in transit and at rest, we do not sell personal data, and we do not train AI on identifiable health information. Apellica is not by default a HIPAA-covered entity; we handle your records under HIPAA-aligned safeguards and the authorization you sign. Our full privacy policy and subprocessor list are at /privacy.

Question 11

Can you call me?

Accepted Answer

Yes. Add your phone number on the intake form and the reviewer can call you after the first read of your letter. You can also call us directly at +1 (888) 777 6120, Monday to Friday 8 AM to 7 PM ET and Saturday 10 AM to 4 PM ET.

Question 12

How long does the appeal process take?

Accepted Answer

Most internal appeals resolve within 30 days; urgent cases within 72 hours; complex cases within 60 days. We typically have an appeal ready to submit within five business days of receiving complete documents.

Question 13

What do I need to upload?

Accepted Answer

Your denial letter (a photo or PDF works), your insurance card, and a brief description of what was denied. We follow up with anything else once the case is reviewed.

Question 14

What if my denial was a long time ago?

Accepted Answer

Most carriers cap appeals at 180 days from the denial letter, with longer windows for Medicare and Medicaid in many situations. Upload your letter and we will tell you whether the deadline still works or whether an alternate path is available.

Question 15

Will appealing affect my insurance going forward?

Accepted Answer

No. Filing an appeal is a federally protected right. Carriers cannot legally retaliate against you for exercising it. If anything unusual happens, we document it.

Question 16

What if my insurer denies the appeal too?

Accepted Answer

Most plans have multiple appeal levels. After internal appeal, federal law gives you the right to an external review by an independent panel. We pursue all available levels before declaring a case closed.

Honest answers, no fine print.

The questions everyone asks first.

Still not sure?