Insurance Denial Analysis

Your insurer left gaps in the denial. We find them.

Claim Lane doesn't write appeals. It reads denial letters and identifies what the insurer failed to resolve in writing, then builds the exact written strategy to make them answer for it.

Sample Denial Analysis

3 gaps found
04 The requested service has been determined to be not medically necessary based on our review of the available clinical information.
07 Your plan requires prior authorization for this service, which was not obtained before the date of service.
11 An equivalent in-network provider was available within a reasonable distance at the time of service.
Lines 4 and 7 contradict: if authorization wasn't obtained, the insurer never evaluated medical necessity. They can't deny on both grounds simultaneously. This is an unresolved position.

Don't appeal. Force them to answer first.

01

Submit your denial

Paste the text of your denial letter. No personal info stored. We read the logic, not the patient.

02

Find the gaps

Claim Lane classifies the failure pattern and identifies contradictions, missing positions, and unresolved logic.

03

Build the record

Get the exact written question to send your insurer. Force a position. Then escalate from the documented record.

Denial patterns we catch

Most denials fall into a handful of logical failures. We know what to look for.

Conflicting Reasons

When the denial letter cites two grounds that can't both be true at the same time.

Medical Necessity Gaps

When "not medically necessary" is stated without explaining what criteria were applied.

Prior Auth Failures

When authorization wasn't obtained but the insurer never made it obtainable.

Network Access Problems

When "in-network alternative available" doesn't survive a real availability check.

Insurance companies write denials hoping you won't read them carefully. We do.

Every denial letter contains the insurer's own reasoning. Sometimes that reasoning doesn't hold up. Claim Lane finds exactly where it breaks down, so you escalate with evidence instead of emotion.

Step 1 of 3

Share your denial letter

Paste the text from your denial letter. We read the logic, not the patient.

Step 2 of 3

Where do we send the analysis?

Your case check is free. No card required.

Step 3 of 3

Analyzing your denial…

We're reading the logic. This takes about 15 seconds.

Final Step

Unlock your written strategy

Get the exact letter to send your insurer — built from your denial's specific gaps.

Benefit Audit — Full Report $129
Written escalation strategy • Insurer-specific arguments • Template letter
Question 1 of 5

Does the denial cite medical necessity or clinical criteria?

e.g. "not medically necessary," "does not meet clinical criteria"

Question 2 of 5

Did it say you needed prior authorization first?

e.g. "prior authorization was not obtained," "pre-certification required"

Question 3 of 5

Did it reference an in-network provider as an alternative?

e.g. "an in-network provider was available," "out-of-network"

Question 4 of 5

Did it call the treatment experimental — or cite a date math issue?

e.g. "experimental/investigational" or "filed late," "timely filing exceeded"

Question 5 of 5

Based on your answers, your denial looks like:

We picked the most likely type. Adjust below if it's wrong.