Know Your Rights
Insurance denials, medical bills, prior authorization problems, and coverage disputes are more common than most people realize. This page shares consumer-friendly facts, updates, and resources to help you better understand the system — and why a denial or confusing bill may still be worth reviewing.
Denials Are Common
KFF reported that HealthCare.gov Marketplace insurers denied about 1 in 5 in-network claims in 2024.
A denial does not always mean the issue is over. It may mean the paperwork, documentation, plan language, or appeal path needs a closer look
Appeals Are Uncommon
Medicare Advantage appeals—
KFF reported that only 11.5% of denied Medicare Advantage prior authorization requests were appealed in 2024, while 80.7% of appealed denials were partially or fully overturned.
That does not guarantee any individual result, but it shows why reviewing the denial and understanding the process can matter.
Prior Authorization Is Changing
Federal rules are pushing toward faster and more transparent prior authorization processes, but consumers and providers still need documentation, deadlines, & follow-up.
Surprise Billing Protections
Some unexpected out-of-network medical bills may be subject to protections under the No Surprises Act. Not every bill qualifies, so details matter.
Insurance rules, deadlines, and appeal options can be confusing — but you do not have to sort through them alone. AdvocateIQ helps you review the paperwork, organize the facts, and understand possible next steps before you decide what to do next.
Start with a No-Cost Quick Review and find out whether your denial, bill, or coverage issue may be worth pursuing.
Click on the link to provide your contact information & upload documents, then select "Free Review" — Submit.