Counterforce Health Team

When Sarah received her son's autism diagnosis, her developmental pediatrician recommended genetic testing to identify any underlying conditions that might affect his treatment plan. But when she submitted the request to her insurance company, she was shocked to receive a denial letter claiming the test was "experimental&

Sarah Jenkins sat in her car, stunned, holding the letter that had just arrived. Her insurance had denied her bariatric surgery—again. This was her third denial in eight months despite her worsening diabetes, joint pain, and sleep apnea. Her doctor had called the surgery "medically necessary," yet

Insurance companies denied a staggering 64% of initial proton therapy requests in 2024, forcing cancer patients to navigate complex appeals while delaying critical treatment by an average of 21 days (and sometimes up to 4 months). This comprehensive guide explains exactly why insurers routinely deny this FDA-approved cancer treatment, reveals

Insurance companies denied an alarming 43% of claims for specialized treatments in 2024, often citing reasons like "experimental procedures" or "not medically necessary" despite physician recommendations and proven clinical benefits. This comprehensive guide explains exactly how to appeal specialized treatment denials, including step-by-step instructions for building

Insurers denied 31% of emergency room claims in 2024, often claiming visits weren't "emergencies" despite patients experiencing severe symptoms. This definitive guide explains exactly how to appeal emergency room claim denials, including step-by-step instructions for gathering documentation, understanding the "prudent layperson standard," and leveraging

Mental health claim denials occur at rates 85% higher than medical claims, despite federal parity laws requiring equal coverage. This comprehensive guide examines why insurers disproportionately reject therapy, psychiatry, and inpatient mental health treatment claims and provides a step-by-step framework for appealing these denials. Learn exactly how to leverage the

Fighting cancer is difficult enough without battling your insurance company. This definitive guide analyzes the most common reasons oncology treatments are denied and provides evidence-based strategies for successful appeals. We examine 5 years of oncology appeal data, identifying which specific language and documentation elements correlate with successful reversals. Learn how

Has your insurer denied coverage for Humira, Remicade, or other biologic medications? This actionable guide provides the exact framework for appealing biologic drug denials for inflammatory bowel disease, rheumatoid arthritis, psoriasis, and other autoimmune conditions. Insurance companies frequently reject these life-changing medications despite their proven efficacy, citing "experimental status&

Are you struggling with a denied MRI claim? You're not alone. Insurance companies reject advanced imaging requests at alarming rates, with MRI denial rates exceeding 30% for some major insurers. This comprehensive guide walks you through the exact step-by-step process for appealing MRI, CT scan, and other diagnostic

Receiving a health insurance claim denial can be both frustrating and frightening. Whether you're facing an unexpected bill for a procedure you thought was covered or being told you can't receive treatment your doctor recommends, understanding your legal rights is essential for navigating these challenges effectively.