We share an interactive tool highlighting the critical role denials and appeals play in financial incentives in U.S. health insurance.

The Financial Calculus of Wrongful Denials

We announce the release of our new pretraining corpus and appeal outcome prediction benchmark.

HICRIC: Law, Policy, and Medical Guidance for Health Insurance Coverage Understanding

We describe barriers to responsibly deploying natural language understanding tools with existing technology, and ways to overcome them.

Toward Generative Contract Understanding Tools

Announcing a submission of a Freedom of Information Act public records request for Medicare data, prepared in collaboration with the Data Liberation Project.

Announcing Our Medicare Appeal FOIA Request

We analyze data from the CMS Medicare Part C and D Qualified Independent Contractor appeal database.

Medicare Advantage QIC Appeal Outcomes

We look into demographic trends in two California databases documenting outcomes of external appeals of health insurance denials.

California External Appeal Outcome Demographics

Announcing the release of our investigation into claims denials in U.S. health insurance based on publicly available data.

Claims Denial Investigation Release

Announcing the release of claims denial data from the Pennsylvania Insurance Department.

Pennsylvania Claims Data Release

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 7: Final Decision. 

The Lifecycle of an Appeal  (Part 7)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 6: External Appeal. 

The Lifecycle of an Appeal  (Part 6)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 5: Initial Appeal Response. 

The Lifecycle of an Appeal  (Part 5)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 4: Initial Appeal. 

The Lifecycle of an Appeal  (Part 4)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 3: Appeal Research.

The Lifecycle of an Appeal (Part 3)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 2: Denial.

The Lifecycle of an Appeal (Part 2)

A guided tour of an insurance denial appeal. We walk through the life cycle of an appeal of coverage denial for the Anser ADA level test for Humira/Adalimumab levels. Part 1: Background.

All Posts

The Financial Calculus of Wrongful Denials

HICRIC: Law, Policy, and Medical Guidance for Health Insurance Coverage Understanding

Toward Generative Contract Understanding Tools

Announcing Our Medicare Appeal FOIA Request

Medicare Advantage QIC Appeal Outcomes