About this site
Coverage and corrections
Exactly what is on this site, what is not, and what we could not confirm.
What is here
Each item is counted once, even if several pages point to it.
| Type | Count |
|---|---|
| Guides | 105 |
| Tools | 30 |
| Letters and scripts | 65 |
| Checklists | 9 |
| Programs and services | 74 |
| Official forms | 26 |
| Coverage types | 20 |
| Denial reasons | 30 |
| States | 51 |
| Topic pages | 42 |
What is not here
- Legal and clinical review. Not done. Read the editorial policy.
- Languages other than English. Not yet.
- Insurer-by-insurer appeal addresses, and drug-by-drug pages. Both go out of date quickly and need a maintenance plan first.
- Searchable past external review decisions. California, New York and Washington publish them; we link to the official databases but do not rebuild them.
- Sending, filing or calling for you. The tools prepare; you send.
- An exhaustive list of local help. The directory is national programs plus state pages. An empty search is a gap in this site, not proof that no help exists.
Deadline rules we could only partly confirm
47 filing steps across 12 kinds of coverage are stored as data and tested. The calculator tells you when it could not fully confirm a rule. These 10 are the ones it flags:
- Job-based or individual private plan: I got a decision from the independent (external) reviewer
- Medicare Part D prescription drug plan: I got a decision from the Medicare Appeals Council that upholds the denial
- Medicaid, decision made by the state Medicaid agency: My state Medicaid agency sent me a notice that denies a service or my eligibility
- Children's Health Insurance Program (CHIP): My state CHIP program denied, delayed, reduced or stopped a health service
- Children's Health Insurance Program (CHIP): My child's CHIP health plan (managed care) denied or cut a service
- TRICARE (military health coverage): TRICARE denied pre-authorization or a continued inpatient stay and I need a fast decision
- TRICARE (military health coverage): I got a reconsideration decision that denies my claim because the care was not medically necessary
- Department of Veterans Affairs (VA) health care: The VA medical facility denied my clinical appeal
- Department of Veterans Affairs (VA) health care: VA denied a health care benefit, such as enrollment, community care or emergency care payment, or travel pay
- Health Insurance Marketplace eligibility decision: My state-run marketplace's appeals entity decided against me
State pages: details we could not confirm
51 state pages list 449 details we could not confirm from an official page, each named on its own page. The most uncertain are below.
- New Mexico: 16 details
- Arizona: 14 details
- District of Columbia: 14 details
- Delaware: 14 details
- North Carolina: 14 details
- North Dakota: 14 details
- Alaska: 13 details
- Alabama: 13 details
- Connecticut: 13 details
- New York: 13 details
- Tennessee: 12 details
- Arkansas: 11 details
Programs we could not fully read
These pages did not load fully, so their records rely partly on earlier research and say so:
- Patient Advocate Foundation appeals guide and sample letters
- Sheer Health
- Washington independent review decision search
Corrections
No corrections have been published yet. When we correct something that could have led someone astray, it will be listed here with the date and what changed. To report a mistake, see how to report one.