Eight modules, the letter templates, and the AI guide. The complete process for fighting a health insurance denial, whatever kind of plan you have.
Denied a GLP-1 medication? Wegovy, Zepbound, Ozempic and the rest have their own rules, their own criteria, and a Medicare program that does not apply to anything else. Go here instead. This course does not cover them in that depth.
It says the claim was denied, it gives a reason in language that explains nothing, and somewhere in the small print there is a deadline you have not calculated. You called and got one answer. You called again and got a different one.
Your plan sent that letter with a reasonable expectation, based on how everyone else behaves, that you would read it, feel bad, and stop.
The single most useful thing to understand is that the appeal is not a favor you are asking for. It is a process the plan is required to run, on a clock, with an outside reviewer at the end of it who does not work for them.
Four different systems govern four different kinds of plan. They have different deadlines, different escalation paths, and different words for the same thing. Reading the wrong one is the most common way a winnable case runs out of time.
Federal rules set the clock, and you have a right to external review by an independent organization once you exhaust the internal appeal.
Your employer pays the claims and wrote the rules. The insurer is administering someone else’s plan, which changes both who to persuade and what you are entitled to demand in writing.
Its own ladder, its own vocabulary, and its own deadlines, with more rungs above the plan than most people realise exist.
State administered, with a fair hearing right and, in many situations, the ability to keep benefits running while the appeal is decided.
The course teaches these as four separate tracks so you read only yours. The free tool tells you which one you are in before you buy anything.
Most first appeals are a letter explaining how much the treatment matters. That letter cannot be answered, so it gets denied.
What moves a file is mechanical. Your plan has a written criteria document listing numbered requirements. Your denial named one of them. The appeal that works quotes that criterion back, attaches the document that satisfies it, and does the reviewer’s job for them in ninety seconds.
Get the rulebook. Answer the rulebook. File it where it goes, with proof.
The chain from your premium to the person who denied you. Why your employer, not your insurer, may be the one who said no, and how to find out which you are dealing with in one phone call.
What kind of no you got, which rulebook governs you, your real deadline, and the triage decision that determines everything else.
Marketplace, self-funded employer, Medicare, and Medicaid, taught as separate tracks so you read only yours. Every deadline, and external review explained as the leverage it actually is.
The document request, with the letters written. On a self-funded plan this is a right under the federal claims rules, not a favor, and almost nobody uses it.
What actually persuades a reviewer, where to find proof you did not know you had, and how to organize it so a busy person can check it fast.
The one-page ask that gets a yes, what belongs in a letter of medical necessity, and how to request and prepare a peer-to-peer review.
Letter anatomy, filing mechanics, proof of filing, and the follow-up scripts for the phone calls.
Second-level appeals, external review, the state insurance complaint, the employer escalation almost nobody makes, when to hire an attorney, and what to do if you lose.
Ten questions, about three minutes. You get your appeal deadline as an actual date, which of the four rulebooks governs your plan, a draft letter built around the reason you were given, and the list of what to attach and in what order.
You never upload the denial letter. You read it and answer questions about it, and what you say about the claim stays in your browser. It asks for your first name and email at the end, to put your name on the letter and send you a copy.
The AI tutor inside the course. Ask it anything about your specific situation and it answers from the course material, with the same rule the rest of the product follows: it will not invent a clinical fact and it will not tell you what to claim.
| What you are comparing | Cost |
|---|---|
| A patient advocate, four hours at $150 | $600 |
| One denied MRI, out of pocket | $400 to $3,500 |
| One denied specialist procedure | thousands |
| Let’s Appeal: The Full Playbook | $79 |
If you do the work and it does not help, we refund you in full.
We will not ask whether you won. We will not ask you to prove you filed anything. And we will not refund based on outcomes in either direction, because tying a refund to whether an appeal succeeded would be a promise about results that nobody can honestly make.
This is a course. You file under your own name. For done-for-you, hire a patient advocate, and expect $100 to $250 an hour. It is often money well spent.
We will refuse, in the course and in the tools.
Answer the ten free questions first. You may get what you need there and not need this.
Nobody can sell you that.
No. It is consumer education about a coverage process. Clinical questions go to your doctor. Where a situation genuinely needs a lawyer, the course says so and names the type.
No. The course gives you the templates and the process, and you review, complete, sign, and file under your own name. We do not represent you.
Module 8 is the escalation ladder: second level, external review by an organization that does not work for your insurer and whose decision binds the plan, the state insurance complaint, and the employer route. Most people stop after one denial.
Use the GLP-1 course instead. The criteria, the Medicare rules, and the renewal trap are specific enough that the general course would leave you short.
Yes, 60 days, on the terms above. It is a real policy, not a hurdle.
It is closer than you think, and it is the one thing on that letter nobody will calculate for you.
60-day refund · Hardship access here