60% of denied claims are overturned on appeal. Most patients never file one.

Your Insurance Company Said No. We Help You Make Them Say Yes.

AI-powered insurance denial appeals, prior authorization disputes, surprise billing challenges, and medical bill audits. Built on CMS billing guidelines and AMA CPT standards.

Fight my denial — $79/mo→

Based on CMS billing guidelines and AMA CPT standards.

Part of the AEQUARA Suite · 46 AI tools · Not legal/financial advice

$935B
In medical billing errors annually
60%
Denial reversal rate with proper appeals
$1,200
Average household medical billing overpayment/year

Every denial challenged. Every right enforced.

⚔️

Insurance Denial Appeals

Identify denial reason codes (CO-4, CO-11, CO-16), cite plan coverage criteria, quote clinical necessity standards. Three-level appeal structure: internal → external → state insurance commissioner.

📋

Prior Authorization Denied

Clinical necessity documentation, peer-to-peer review request language, step therapy exception arguments, and urgency language when delays cause patient harm.

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Medical Bill Audit

Duplicate billing, upcoding, unbundling, wrong diagnosis codes — every error identified with dollar impact. Includes No Surprises Act violation scan.

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EOB Explanation

Plain English translation of every line item. Which amounts you owe vs. insurer vs. write-off. Red flags for errors highlighted automatically.

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Surprise Billing Disputes

No Surprises Act (42 U.S.C. § 300gg-111) violations identified and challenged. Out-of-network emergency charges and balance billing by in-network facilities.

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Formal Appeal Letters

Certified mail-ready appeal letters with member ID, claim numbers, CPT/ICD codes, clinical rationale, regulatory citations, and 30-day response demands.

TRUSTED BY EARLY USERS · ★★★★★ AVERAGE

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✓ Verified

My insurance denied a $28,000 surgery as "not medically necessary." AEQUARA Health drafted the appeal citing the exact LCD criteria. Reversed in 19 days.

M
Marcus T.
Atlanta, GA
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✓ Verified

Prior auth denied for my daughter's medication. The peer-to-peer review letter was exactly what the doctor needed. Approved on first appeal.

J
Jennifer L.
Portland, OR
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✓ Verified

Found $3,800 in billing errors on my hospital stay — duplicate charges and a No Surprises Act violation. Resolved in three weeks.

S
Sarah K.
Austin, TX

Unlimited appeals. Unlimited audits. One subscription.

Monthly

$79

Full access to all five tools: denial appeals, prior auth, bill review, EOB explanation, surprise billing. Cancel anytime.

  • Insurance denial appeal letters
  • Prior authorization appeals
  • Medical bill error audit
  • EOB plain-English explanation
  • Surprise billing / No Surprises Act
  • Evidence checklist for every case
  • Unlimited use — no per-case fees

30-day money-back guarantee

MOST POPULAR

Annual

$699

Save $249 vs. monthly. Best for anyone managing ongoing denials, chronic condition coverage disputes, or annual benefit cycles.

  • Everything in Monthly
  • $249 savings vs. monthly billing
  • Priority processing
  • All future tool updates included

30-day money-back guarantee

Frequently asked

What types of insurance denials can AEQUARA Health help with?

All major denial types: medical necessity denials, prior authorization denials, out-of-network claims, experimental treatment denials, and coordination of benefits disputes. Works with commercial, employer, Medicare, Medicaid, and ACA Marketplace plans.

How does the appeal letter actually work?

The AI identifies your specific denial reason code (CO-4, CO-11, CO-16, etc.), cites your plan's own coverage criteria or the applicable CMS LCD/NCD, quotes the clinical necessity standard being met, and drafts a formal certified-mail appeal letter. You fill in your name, member ID, and claim number — then mail it.

What is the No Surprises Act?

The No Surprises Act (42 U.S.C. § 300gg-111), effective January 2022, bans balance billing for emergency services and out-of-network care at in-network facilities. Violations are common — hospitals routinely send bills they are legally prohibited from collecting.

What if my prior authorization was already denied once?

First-level denials are often rubber-stamped. The tool generates language for a peer-to-peer review request — your physician speaks directly with the insurer's medical director. This reverses roughly half of all prior auth denials. If that fails, it generates the external appeal request.

Does this work for Medicare and Medicaid denials?

Yes. The appeal processes for Medicare (ALJ hearings, QIC reviews) and Medicaid (state fair hearings) are different from commercial insurance and the tool adapts to each. CMS-specific LCD and NCD citations are included where applicable.

Is this legal advice?

No. AEQUARA Health provides research, regulatory citations, and document drafting assistance. It is not a substitute for a licensed healthcare attorney or patient advocate for complex, high-stakes disputes. Consult a professional when the amounts or legal complexity warrant it.