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For journalists and analysts

Apellica press kit

Resources for editorial coverage of Apellica and the U.S. health- insurance denial-appeals landscape. For interviews, data requests, or expert comment, contact press@apellica.com.

Boilerplate description

Apellica, Inc. is a U.S. health-insurance-appeal preparation firm headquartered at One World Trade Center, New York. Apellica acts as the authorized representative of denied policyholders to prepare and file evidence-based appeals citing the controlling federal regulation and the carrier's own medical-policy criteria. The firm serves all 50 states under ACA marketplace, employer-sponsored, ERISA, Medicare Advantage, and Medicaid managed-care plans. Apellica operates on contingency, there is no charge unless the appeal succeeds.

Citable statistics

Every figure here traces to a public source. Please cite the source, not Apellica, when using these numbers in your story.

1 in 5
in-network claims denied each year
KFF, HealthCare.gov claims data for 2023 (20%)
~50%
of appealed denials are overturned
KFF marketplace denial-and-appeal data
fewer than 1%
of denials are ever appealed nationally
KFF + AHIP industry reporting
29 CFR §2560.503-1
the federal regulation governing ERISA claim procedures
U.S. Code of Federal Regulations
45 CFR §147.136
the federal regulation governing external review
U.S. Code of Federal Regulations

Logos

Coverage areas

Apellica accepts cases involving any of the denial types below across all 50 U.S. states. Apellica does not accept oncology, cancer-treatment, or rare-disease claims at this time; visitors with those denials are referred to their state Department of Insurance external-review program and to the Patient Advocate Foundation at patientadvocate.org.

  • Medical-necessity denials
  • Prior-authorization denials
  • Formulary / step-therapy denials
  • Out-of-network denials
  • Experimental / investigational denials
  • Timely-filing denials

Headquarters

Apellica, Inc.
One World Trade Center, Suite 8500
New York, NY 10007
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