When your insurance company denies coverage for treatment, tests, or providers, it feels like a dead end. But legally and practically, patients have powerful rights to challenge these denials. This course provides a step-by-step action plan to decode denial letters, file effective appeals, leverage federal and state protections, and escalate disputes to external reviews or regulators. By the end, students will walk away with a Coverage Denial Response Toolkit containing appeal templates, complaint letters, negotiation scripts, and checklists — everything needed to fight back against wrongful denials.
Course Objectives
By the end of this course, students will be able to:
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Understand common reasons insurers deny coverage.
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Break down denial letters for legal and procedural flaws.
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Gather medical and legal evidence to support appeals.
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File internal appeals with insurers correctly and on time.
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Escalate to external reviews under ACA, ERISA, or state law.
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Use negotiation strategies to secure coverage or alternative payments.
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File complaints with regulators when insurers act in bad faith.
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Build a repeatable action plan for handling future denials.
