Counterforce Health Team

The Insurance Denial Crisis, Shocking Numbers You Need to Know In today's healthcare landscape, a disturbing trend continues to unfold. Nearly one in five insurance claims (19%) submitted for in-network services are denied, according to the most recent analysis of HealthCare.gov marketplace plans. For out-of-network claims, the

Your doctor has recommended rhinoplasty to address your breathing difficulties, repair structural damage, or correct a congenital abnormality. You've submitted the claim to your insurance company with hope and expectation—only to receive that dreaded denial letter. This scenario plays out thousands of times each year across America,

Your doctor prescribed physical therapy to help you recover from an injury, manage chronic pain, or regain mobility. Then the frustrating news arrives: your insurance company denied your claim. According to recent healthcare statistics from the American Medical Association, physical therapy is among the most commonly denied medical services, with

"I'm sorry, but your insurance has denied your surgery request." These words hit James Morgan like a physical blow. For months, he had endured debilitating back pain that radiated down his leg, making simple tasks like putting on socks or picking up his grandson impossible. After

Mark woke up exhausted—again. Despite finally getting diagnosed with obstructive sleep apnea after years of debilitating fatigue, his insurance company had denied coverage for his prescribed CPAP therapy. The denial letter claimed his condition wasn't "severe enough" to warrant treatment, despite his sleep study showing

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