Product
Insurance Appeal Writer
Paste your insurance denial letter and get a filed-ready appeal in one pass. It classifies the denial into one of five buckets (medical necessity, experimental, prior authorization, coding error, out of network), lifts the plan's own language verbatim so your appeal argues against what the letter actually said, and produces the full formal appeal letter in the skeleton that bucket demands. It also emits a red-flag panel of tempting lines NOT to write, a required-elements checklist keyed off what you actually pasted, and a computed deadline block (internal appeal, insurer decision window, external-review by-date) based on your plan type. Every clinical fact traces to the doctor's letter you paste, never invented; if a fact needed to close the argument is missing, it lists 'ask your doctor to document X' instead.
About this tool
What does insurance appeal writer do?
Paste your insurance denial letter and get a filed-ready appeal in one pass. It classifies the denial into one of five buckets (medical necessity, experimental, prior authorization, coding error, out of network), lifts the plan's own language verbatim so your appeal argues against what the letter actually said, and produces the full formal appeal letter in the skeleton that bucket demands. It also emits a red-flag panel of tempting lines NOT to write, a required-elements checklist keyed off what you actually pasted, and a computed deadline block (internal appeal, insurer decision window, external-review by-date) based on your plan type. Every clinical fact traces to the doctor's letter you paste, never invented; if a fact needed to close the argument is missing, it lists 'ask your doctor to document X' instead.
How does Insurance Appeal Writer work?
Paste the denial letter your insurer sent, tell it your plan type (employer/ACA marketplace/Medicare/Medicaid), pick the appeal bucket (medical necessity, experimental or investigational, prior authorization, coding error, or out-of-network), write a sentence or two on why the treatment mattered for you, and optionally paste any letter of medical necessity your doctor wrote. One AI pass returns a full appeal letter anchored to the exact denial reason, verbatim quotes of the plan language the insurer cited (so the appeal engages the plan's own words, not a paraphrase), a deadline block with the filing window, the insurer decision deadline, and the external review step, a what-NOT-to-say red-flag panel of phrases that hurt appeals, and a doctor documentation gaps callout listing the specific facts the appeal would be stronger with (so you can ask your doctor to add them).
How is this different from asking ChatGPT to write my appeal?
ChatGPT writes a generic protest letter in its default voice and cheerfully invents clinical facts your doctor never told it. Insurance Appeal Writer runs a structured single pass with four hard rules: it echoes the plan language verbatim (so the appeal argues against the exact clause cited, not a fuzzy paraphrase), it uses a different letter skeleton per denial bucket (medical necessity reads differently from prior-auth, which reads differently from a coding error), it never invents clinical facts and instead lists doctor documentation gaps for you to close, and it does the deadline math from your denial date and plan type. It also warns you off the phrases that get appeals dismissed (emotional threats, admitting you cannot afford it, blanket bad-faith accusations).
Does it invent medical facts or plan details my doctor didn't tell it?
No. The only facts the letter states as yours are the ones you pasted: the denial text, the plan language the insurer cited, and any letter of medical necessity your doctor wrote. When a stronger appeal would need a clinical fact you did not supply (a specific lab value, a documented failed prior therapy, a functional-impairment note), the tool does not invent it. It emits a doctor_documentation_gaps entry saying 'ask your doctor to document X, because appeals in this bucket usually turn on it', so you can close the gap before you file.
What kinds of denials does it handle?
Five buckets, each with its own letter skeleton. Medical necessity (the insurer says the treatment was not needed for your condition) argues from clinical guidelines and your documented history. Experimental or investigational (they say the treatment is not proven) argues from FDA approval, guideline recommendations, and peer-reviewed evidence. Prior authorization (they say you skipped the auth step) argues from urgency, retroactive auth pathways, and steerage failures. Coding error (they denied on a wrong CPT/ICD-10 code) argues from the correct code and asks for a rebill, not a full appeal. Out-of-network (they say the provider was not in-network) argues from network adequacy, no-in-network-available, or emergency exceptions.
What appeal deadlines does it calculate?
For ERISA employer plans and ACA marketplace plans: 180 days from the denial date to file an internal appeal, insurer must decide within 30 days for pre-service or 60 days for post-service, then 4 months to request external review after the final internal denial. For Medicare Advantage: 60 days from the denial notice to file a reconsideration. Medicaid deadlines are state-dependent, so the deadline block flags this and tells you to check your state's fair-hearing rules. The deadline block prints the exact calendar date each window closes, computed from the denial date you entered.
Which tier should I pick, Quick or Deep?
Quick (15 tokens) produces the same appeal-letter structure but with a shorter medical-necessity paragraph and skips the doctor_documentation_gaps enumeration. It is fine for a coding-error rebill or a straightforward prior-auth appeal where the facts are clean. Deep (30 tokens) is full rigor: longer medical-necessity argument, precise deadline math per plan type, and the full doctor documentation gaps list so you know what to ask your physician to add. Pick Deep if the treatment actually matters, if the denial was medical-necessity or experimental, or if this is your one shot at internal appeal before external review.
How much does it cost, and do I need a subscription?
No subscription. Quick is 15 tokens per appeal, Deep is 30 tokens. Tokens are a prepaid platform credit you buy once and spend across any produde tool, so you pay per appeal instead of a monthly fee. This is the AI-tools-without-the-subscription model: pay-per-use for a job you might do once a year or three times in a bad month. If a run fails, the full token cost is refunded to your wallet automatically.
Who is it for?
The patient staring at a denial letter with a filing window closing, who does not know what to write and cannot afford a healthcare-advocacy retainer. Caregivers and family members advocating on behalf of a parent, spouse, or child. Anyone whose employer, marketplace, Medicare Advantage, or Medicaid plan denied a treatment they and their doctor believe is necessary. It is not for physicians filing appeals in high volume (Counterforce Health is that tool); this is a single-purpose focused tool for the individual patient writing one appeal, well. It is a template, not legal counsel.
What does it cost?
From 15 tokens. Pick a tier on the form above. Produde tokens are a prepaid platform credit; buy them once and spend on any tool.
Do I pay if a run doesn't complete?
No. You only pay for results. If a run can't finish, its full token cost stays in your wallet automatically.
Is my data stored?
Your input and the run output are saved to your account so you can browse history. They are not sold, shared with advertisers, or used to train shared models. See privacy for details.