What we do, and what we ask of you.

A service that helps you understand a Medicare Advantage denial letter and appeal it. We are not a law firm, and we don’t give legal or medical advice. We are not your representative: the appeal is yours, in your name or the enrollee’s, and you decide whether it goes out.

Your plan, or an independent reviewer after it, makes the decision. We can’t promise what it will be.

The deadline printed on your letter is yours to meet. We quote it back to you and aim to have your appeal ready well before it. If it is close, follow the instructions on the letter yourself. If care is ending in the next few days, call the number on the notice today.

Please give us accurate information, and upload only documents you are allowed to share. If you act for someone else, you confirm that you may: for example with a power of attorney or an appointment of representative form, which you send us with the appeal.

Checking your letter is free. If we handle the appeal for you, you pay $299, only if the decision is reversed. If we prepare it and you send it, you pay a $49 deposit when you accept, and $100 more only if the decision is reversed. The price you accept is the price you pay.

“Reversed” means the plan, or the independent reviewer after it, reverses the decision in whole or in part. The deposit pays for writing your appeal and is not refunded. If we stop work on your case before your appeal is ready, you pay nothing and we refund any deposit.

We email you a secure link to pay. We never ask for card details on this site.

When you approve and sign your appeal, you ask us to fax it, with the documents you uploaded, to your plan in your name. The fax confirmation shows the date the plan received it. The plan answers you, not us; upload its answer on your page and we’ll tell you what it means.

As far as the law allows, our total liability to you for anything to do with Claim Back is limited to what you paid us for your case. Nothing here limits what the law does not allow us to limit.

If these terms change, we’ll post the new version here with a new date. A case you accepted keeps the terms and price it was accepted under.