We’ve all seen the headlines. We’ve all felt the frustration. And yet… prior authorization denials are still not being appealed.

The Facts:
- Only about 11% of denials are ever appealed.
- Of those appeals, roughly 90% are overturned.

That means payers are banking on us not fighting back. And too often, they’re right.

WHY YOU SHOULD APPEAL
- High odds of success: 9 out of 10 appeals get overturned when challenged.
- Protect patient care: Denials delay or block necessary treatment. Appeals keep care on track.

Protect your revenue: Every overturned denial is revenue rightfully earned for services already delivered.

HOW TO APPEAL
1. Act fast- File within the payer’s deadline (usually 30–60 days).
2. Be thorough-Address the denial reason directly, quote payer policy and highlight contradictions.
3. Use strong clinical documentation- Include notes, referrals, test results and progress reports to prove medical necessity.
4. Standardize your process- Create a template for common denials so your team isn’t starting from scratch each time.
5. Follow up- Like our normal authorization requests, track every appeal and escalate when payers don’t respond. Persistence matters!

The truth is simple: appealing isn’t just paperwork- it’s advocacy... For your patients. For your practice. For the care that matters.