Celtic denied your claim in Tennessee. Here is your deadline.

You are not alone, and here is the measured version of that sentence: 1,645,943 in-network claims were denied by Celtic Insurance Company in Tennessee in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.

• Of the 5 insurers reporting a denial rate in Tennessee, Celtic Insurance Company is the fifth highest at 18.9%. The highest in the state is 23.5% and the lowest is 18.9%.
• That is 0.2 percentage points above the 18.7% national average across this dataset, and 1.2 points below the Tennessee average of 20.1%.
• Behind the percentage: 8,726,180 in-network claims were processed under 19 plans in Tennessee, and 1,645,943 of them came back denied.
• For every 10,000 claims Celtic Insurance Company denied, about 16 came back as an internal appeal. The other 9,984 stopped at the letter.
• Its most-recorded denial reason is administrative reason at 20.6% of its categorized denials, against 22.5% nationally, a lighter share than the country as a whole. That is the denial mix, not an outcome rate.
• In Tennessee, Celtic Insurance Company reported 18.9%, and the same company files in 8 other states in this file, where the rate is not the same in any of them: 28.2% in Delaware, 24% in Oklahoma, 21.4% in Alabama, down to 16.1% in Arkansas. Which state the plan was bought in moves the odds more than the brand on the card does.
• Celtic Insurance Company accounts for 36.1% of every in-network claim denied in Tennessee in this file.
• By raw volume it is the tenth largest source of denials among the 158 insurer-state records in the file that report one.
• After that, its second-most-recorded reason is service excluded from the plan, 202,261 claims, 15.4% of its categorized denials.
• Third on its own list is referral required, 194,372 claims, 14.8% of what Celtic Insurance Company categorized in Tennessee. Between them the top three account for 50.8% of its categorized denials.
• Where Celtic Insurance Company differs most from the national mix is not medically necessary: 12.1% of its categorized denials in Tennessee against 4.6% across the file.
• Read the other way round: 7,080,237 of those 8,726,180 in-network claims were paid, 81.1% of everything Celtic Insurance Company processed in Tennessee.
• Spread across the 19 plans it reports in Tennessee, that is about 86,629 denied claims per plan, on about 459,273 claims processed per plan.
• Its reason columns add up to 1,310,756 categorized rows against 1,645,943 denials, 79.6% of them, and every reason share on this page is a share of that first figure rather than of the second.
• Its smallest recorded category in Tennessee is provider out of network, 74,998 claims, 5.7% of what Celtic Insurance Company categorized there.
• Against the file as a whole, this one record is 1.9% of the 84,502,749 in-network claim denials reported by every issuer in it.

What happened to appeals

What that record means for your own Celtic Insurance Company letter, and by when. Celtic Insurance Company recorded 1,645,943 denials in Tennessee and no separately reported appeal outcome, so this page cannot tell you how its Tennessee appeals went, the Celtic Insurance Company rows in the plan-year 2026 release of the CMS Transparency in Coverage file, read September 5, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 60 calendar days after you receive its notice (42 CFR 422.582(b)) and Medicaid managed care the same 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your Celtic Insurance Company notice and file well inside whichever of those windows is yours. The free steps are above; the $29 kit is the same clock with the letters pre-filled for Celtic Insurance Company in Tennessee. One payment. No subscription. No cut of your claim.

Celtic Insurance Company inside Tennessee

Your denial did not happen in a national average. It happened in a state market, alongside 5 other insurers reporting into the same federal file, and these are that market's own figures.

• Across the whole of Tennessee, the 6 insurers reporting in this file processed 22,656,628 in-network claims and denied 4,559,085 of them, a state denial rate of 20.1%. Celtic Insurance Company is one of those 6.
• That puts Tennessee sixth of 30 states by denial rate, 1.4 points above the 18.7% national average, before you get to what Celtic Insurance Company did inside it.
• Tennessee recorded 14,943 internal appeals against those denials: one appeal for every 305 claims the state's insurers refused. Celtic Insurance Company's own ratio is one for every 633.
• Independent external review was reached 162 times in the whole of Tennessee, once for every 28,143 denials, against one in 14,369 nationally. How many came from Celtic Insurance Company's denials is not on the record, that is the Tennessee figure this page names as absent at the top and sources at the foot.
• Of the Tennessee external reviews that were filed, 30 were overturned, 18.5%. That percentage is measured on 162 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Celtic Insurance Company.
• The reason Tennessee's insurers record most often is administrative reason, 1,068,753 claims, 28.4% of the state's categorized denials. Celtic Insurance Company records the same one most often, so your letter is likely to say it too.
• The other insurers a Tennessee reader could have bought from run from 23.5% (Oscar Insurance Company) to 20.3% (Cigna Health and Life Insurance Company). Celtic Insurance Company at 18.9% sits below all of them.
• Put the two together and Celtic Insurance Company is responsible for 36.1% of every in-network claim denied in Tennessee in this release, from 38.5% of the claims the state's insurers processed.
• Every Tennessee figure in this section is that state's own row in the same federal file Celtic Insurance Company's numbers above come from, CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain, and the full Tennessee page is free at /states/tennessee.

What Celtic Insurance Company denies most

The most common denial reason recorded for Celtic Insurance Company plans in Tennessee is administrative reason. How that denial is beaten →

The last column is each reason's share of all categorized denials nationally, so you can see where Celtic Insurance Company's mix in Tennessee differs from everyone else's. This is denial mix, not overturn rate by reason, the federal file does not report appeal outcomes broken down by denial reason, and we do not imply otherwise.

The three steps at the top of this page are the whole of what you have to do tonight. The longer version, what the internal appeal has to contain, how the independent stage works, and how to ask for expedited handling when waiting would seriously jeopardize your health, is published free here.

Who appeals what at Ambetter (Centene), the insurer's own routing table

Ambetter (Centene) publishes a table of which denial scenarios are appealed by you, the member ("customer appeal") and which only your health care provider can appeal. Almost no patient ever sees it, and appealing a denial that only your provider has standing to appeal burns time inside a fixed window. Quoted from Ambetter (Centene)'s published policy (a page written for health care providers (Texas plan page)), checked 2026-08-25. It is brand-level and applies to Celtic Insurance Company in Tennessee the same as to every other Ambetter (Centene) entity in the file.

Operational facts from the same policy

• Medical-necessity appeal window: 180 calendar days
• Standard resolution clock: 30 calendar days
• Expedited appeal clock: 1 working day / 72 hours from complete information
• Submission (Texas plan): Complaints Department, 5900 E. Ben White Blvd., Austin, TX 78741 · Fax 1-866-683-5369 , Texas plan's address — each state plan publishes its own.
• Member appeal window: 180 calendar days, orally or in writing , Member-side confirmation of the 180-day window; also confirms the 30-day resolution clock ('shall not exceed 30 calendar days from the date Ambetter receives the appeal') and the expedited 1-working-day / 72-hour-written clock.
• Member APPEALS address differs from the complaints address: Appeals Department, 5900 E Ben White Blvd., Austin, TX 78741 · Fax 1-866-918-2266 , Same street address as the Complaints Department but a different fax: appeals go to 1-866-918-2266, grievances/complaints to 1-866-683-5369. The plan page's complaints fax is not the appeals fax.
• External review via MAXIMUS: four months from the final internal decision; standard decided ≤45 days, expedited ≤72 hours , Route: Externalappeal.com, fax 1-888-866-6190, or mail to MAXIMUS Federal Services, 3750 Monroe Avenue, Suite 705, Pittsford, NY 14534. Matches the federal 4-month right this site publishes.

Sources: Ambetter (Centene), "Grievance and Appeals (Ambetter from Superior HealthPlan, Texas)", quoted, not paraphrased; audience: health care providers (Texas plan page); checked 2026-08-25. Ambetter (Centene), "Appeals and Grievances Guide (Ambetter from Superior HealthPlan, Texas — member guide, last updated December 2024)", quoted, not paraphrased; audience: members; checked 2026-08-26. Brand-level policy, applied here because Celtic Insurance Company is an Ambetter (Centene) entity. Your own denial letter and plan documents govern your specific case.

Questions

Everything you need for your Celtic Insurance Company appeal in Tennessee: your two deadlines, the argument that fits your denial reason, the letters, the clinician brief, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.