When insurance says no, that’s where we start.
Denied claims, surprise bills, prior authorizations that never come — the system counts on you giving up. We don’t.
health insurance claims is denied the first time it’s submitted
of those denials get appealed — most people simply give up
of appealed denials are overturned — when you fight back, the odds are on your side
Fortune 500 companies buy healthcare advocacy for their people. Now your team can have it too: a bank of advocacy hours your employees can use when a claim goes sideways — a benefit they’ll actually remember at renewal time, for less than a ping-pong table.
A denied surgery. A bill that doubled. A parent’s care nobody will coordinate. Bring us the file — we read the plan language, build the appeal, and deal with the carrier so you can deal with life. Casework happens by phone and secure email, so families beyond Colorado are welcome too.
Plan documents, ERISA appeal rights, carrier behavior, the difference between a denial that’s wrong and one that’s merely lazy — this is the fluency employers pay HR directors for, now working for you.
Roughly half of the claims that get appealed are overturned. The catch is that fewer than one in a hundred denials is ever appealed at all — the carrier is counting on you not knowing that.
Most employer plans give you 180 days from the denial notice to file an internal appeal, and Colorado law and ERISA both add an independent external review after that. Urgent-care denials run on a clock of days, not months, so call as soon as the letter arrives.
Yes. Employers retain Advocate HR to support their people through denials as a benefit. Your medical details stay between you and the advocate — your employer never sees them.
Employer engagements are Colorado-based. Family casework happens by phone and secure email, so we take denial appeals from families anywhere in the U.S.