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FAQs About Insurance Appeals

What kinds of surgery, medical procedure and treatment appeal cases does PRIA Appeals handle?

PRIA Appeals is able to help with insurance appeals for coverage denials for several different medical areas, including:

If you have been denied coverage for a medical procedure or treatment recommended by your doctor, contact us.

What is an authorized representative?

With any health insurance plan, you are entitled to designate an authorized representative to help you appeal an insurance denial, and your insurance company is obligated to work with that authorized representative on the matter. Appeals are not legal proceedings, so you do not have to hire a lawyer to be your authorized representative. If you work with PRIA Appeals, you will designate us as your authorized representative and we will work with the insurance company on your appeal and advocate on your behalf.

When should I contact PRIA Appeals?

If you have been denied coverage for a medical treatment or surgery, contact us as soon as possible. The sooner we get involved, the better we can advocate for you. You can even contact us before you have been denied if you are unsure about the process or worried you may be denied. We can help then too.

How much is this going to cost me?

Our fees vary depending on the extent of service you need, but they are surprisingly affordable. All of our appeal services are performed on a fixed fee basis rather than an hourly rate based on our time spent on the appeal, so you know exactly how much you have to pay up front. We are happy to work with you so that fees are never an obstacle to you getting the help you need.

Can you help me get money back if I have already had surgery as a cash pay patient?

Yes! If you paid cash for a procedure that was wrongly denied by your insurance company or self-insured plan, we may be able to get you some or all of your money back.