The evidence
The closed library behind every letter.
Merits only quotes from the sources below — matched to your exact code, plan type, and payer, quoted word for word, and re-checked against the source before you see the letter. Anything unsupported is flagged for your review, never stated as fact.
- 484
- insurer policies cited — across 43 insurers
- 40,000+
- external-review rulings, studied for what overturns a denial
- 1.7M
- coding rules — NCCI, ICD-10 & HCPCS
- 0
- invented citations — the closed corpus won't allow one
43 insurers' own medical policies — 484 in all
their published coverage criteria, quoted back to them in an appeal to that same payer
Medicare coverage determinations
the LCDs and NCDs for your exact procedure code, with the live criteria
40,000+ external-review rulings
real rulings from independent review organizations — what reviewers actually accept, not what the policy says on paper
240 FDA-approved drug labels
the on-label indication for the high-cost drugs behind the biggest denials
1.7M coding rules — NCCI, ICD-10 & HCPCS
every active coding edit matched to your procedure pair, flagging the technical ground the denial rests on
The federal appeal-rights law
ERISA, ACA, and Medicare appeal rights, captured word-for-word
Clinical & specialty guidelines
USPSTF and specialty-society criteria (e.g. ACR appropriateness), matched by code
State external-review rules
deadlines and external-review rights, mapped across all 50 states + DC
Sources are re-verified on every citation; a source that goes dark leaves the pool automatically. Regulatory text is captured verbatim from the eCFR and U.S. Code — never paraphrased.
See the stack argue your own denial.
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