Imperial Health Plan of the Southwest denied your claim in Utah. Here is your deadline.
Put in the date on your Imperial Health Plan of the Southwest, Inc. notice and get both federal deadlines as calendar dates.
Free, for an Imperial Health Plan of the Southwest, Inc. denial in Utah, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
Imperial Health Plan of the Southwest, Inc. denied 87 of 261 in-network claims in Utah; every one of those denials had these same two dates on it. Across Utah as a whole the insurers in this file denied 18.6% of in-network claims, 1,781,916 of them, and 6,469 were appealed.
Imperial Health Plan of the Southwest, Inc. denied 33.3% of in-network claims in Utah, 87 claims out of 261.
Insurance got denied, what to do next?
Those 87 denials are 0% of every in-network denial recorded in Utah in this release, which makes Imperial Health Plan of the Southwest, Inc. the 6th largest source of denials of the 6 insurers reporting there. Spread across its 5 plans in the state that is about 17 denials per plan. Every one of those denials carried the same two dates the tool at the top of this page works out.
Two dates matter more than anything else on this page, and they run the same in Utah as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone, and here is the measured version of that sentence: 87 in-network claims were denied by Imperial Health Plan of the Southwest, Inc. in Utah 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 6 insurers reporting a denial rate in Utah, Imperial Health Plan of the Southwest, Inc. is the first highest at 33.3%. The highest in the state is 33.3% and the lowest is 14.8%.
- That is 14.6 percentage points above the 18.7% national average across this dataset, and 14.7 points above the Utah average of 18.6%.
- Behind the percentage: 261 in-network claims were processed under 5 plans in Utah, and 87 of them came back denied.
- Not one of those denials reached independent external review, the stage whose decision the plan is required by law to accept, and where nationally 32.8% are overturned.
- Its most-recorded denial reason is other reasons at 71.9% of its categorized denials, against 32.3% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- Imperial Health Plan of the Southwest, Inc. accounts for 0% of every in-network claim denied in Utah in this file.
- By raw volume it is the 158th largest source of denials among the 158 insurer-state records in the file that report one.
- After that, its second-most-recorded reason is referral required, 41 claims, 20.9% of its categorized denials.
- Third on its own list is member not covered, 14 claims, 7.1% of what Imperial Health Plan of the Southwest, Inc. categorized in Utah. Between them the top three account for 100% of its categorized denials.
- Where Imperial Health Plan of the Southwest, Inc. differs most from the national mix is other reasons: 71.9% of its categorized denials in Utah against 32.3% across the file.
- Read the other way round: 174 of those 261 in-network claims were paid, 66.7% of everything Imperial Health Plan of the Southwest, Inc. processed in Utah.
- Spread across the 5 plans it reports in Utah, that is about 17 denied claims per plan, on about 52 claims processed per plan.
- Its reason columns add up to 196 categorized rows against 87 denials, 225.3% 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 Utah is member not covered, 14 claims, 7.1% of what Imperial Health Plan of the Southwest, Inc. categorized there.
- Against the file as a whole, this one record is 0% of the 84,502,749 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The reason Imperial Health Plan of the Southwest, Inc. records most often in Utah is other reasons, but yours may be one of the other 8, copy the exact wording and code off your own letter tonight, because that sentence is what your appeal has to answer.
- Ask Imperial Health Plan of the Southwest, Inc. in Utah for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. 87 claims were denied here in a single year and not one was escalated; the deadline is what decides whether anyone reads the argument.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
How that compares
| Denial rate | Rate | Difference |
|---|---|---|
| Imperial Health Plan of the Southwest, Inc. | 33.3% | , |
| Utah average | 18.6% | +14.7 pts |
| National average (this dataset) | 18.7% | +14.6 pts |
Imperial Health Plan of the Southwest, Inc. denies 14.6 percentage points more of its in-network claims than the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Imperial Health Plan of the Southwest, Inc.) | not reported | not reported |
| External review (independent) | 0 | 0% |
The gap nobody escalated
87 claims denied. not reported internal appeals filed. None reached independent external review. Nationally 32.8% of external reviews are overturned and the decision binds the plan.
That is arithmetic from the reported figures, not a prediction: nobody can say what those specific denials would have done at review, because they never got there. What the numbers do establish is that the binding stage was almost entirely unused here.
What that record means for your own Imperial Health Plan of the Southwest, Inc. letter, and by when. Imperial Health Plan of the Southwest, Inc. recorded 87 denials in Utah and no separately reported appeal outcome, so this page cannot tell you how its Utah appeals went, the Imperial Health Plan of the Southwest, Inc. 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 Imperial Health Plan of the Southwest, Inc. 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 Imperial Health Plan of the Southwest, Inc. in Utah. One payment. No subscription. No cut of your claim.
Imperial Health Plan of the Southwest, Inc. inside Utah
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 Utah, the 6 insurers reporting in this file processed 9,574,696 in-network claims and denied 1,781,916 of them, a state denial rate of 18.6%. Imperial Health Plan of the Southwest, Inc. is one of those 6.
- That puts Utah 13th of 30 states by denial rate, 0.1 points below the 18.7% national average, before you get to what Imperial Health Plan of the Southwest, Inc. did inside it.
- Utah recorded 6,469 internal appeals against those denials: one appeal for every 275 claims the state's insurers refused.
- Independent external review was reached 130 times in the whole of Utah, once for every 13,707 denials, against one in 14,369 nationally. None of them came from Imperial Health Plan of the Southwest, Inc.'s denials.
- Of the Utah external reviews that were filed, 53 were overturned, 40.8%. That percentage is measured on 130 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Imperial Health Plan of the Southwest, Inc..
- The reason Utah's insurers record most often is other reasons, 1,333,104 claims, 57.8% of the state's categorized denials. Imperial Health Plan of the Southwest, Inc. records the same one most often, so your letter is likely to say it too.
- The other insurers a Utah reader could have bought from run from 22.9% (Molina Healthcare of Utah) to 14.8% (Regence BlueCross BlueShield of Utah). Imperial Health Plan of the Southwest, Inc. at 33.3% sits above all of them.
- Put the two together and Imperial Health Plan of the Southwest, Inc. is responsible for 0% of every in-network claim denied in Utah in this release, from 0% of the claims the state's insurers processed.
- Every Utah figure in this section is that state's own row in the same federal file Imperial Health Plan of the Southwest, Inc.'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 Utah page is free at /states/utah.
What Imperial Health Plan of the Southwest, Inc. denies most
The most common denial reason recorded for Imperial Health Plan of the Southwest, Inc. plans in Utah is other reasons. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Other reasons | 141 | 71.9% | 32.3% |
| Referral required | 41 | 20.9% | 8.4% |
| Member not covered | 14 | 7.1% | 6.6% |
The last column is each reason's share of all categorized denials nationally, so you can see where Imperial Health Plan of the Southwest, Inc.'s mix in Utah 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.
Put the date from your notice in and get the two calendar dates, with the days remaining.
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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.
Questions
Is Imperial Health Plan of the Southwest, Inc.'s denial rate in Utah high?
33.3% against a national average of 18.7% across the plans in this dataset. It is above average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed an Imperial Health Plan of the Southwest, Inc. denial in Utah, and how many won?
Appeal volumes were not separately reported for Imperial Health Plan of the Southwest, Inc. in Utah. Across Utah as a whole 6,469 internal appeals were filed against 1,781,916 denials, one for every 275 refused, and that is the state figure, not this company's. Nationally, 32.6% of internal appeals and 32.8% of external reviews are overturned.
How does Imperial Health Plan of the Southwest, Inc. compare with other insurers in Utah?
Of the 6 insurers in Utah with a reported denial rate, Imperial Health Plan of the Southwest, Inc. ranks 1 highest at 33.3%. The highest in Utah is Imperial Health Plan of the Southwest, Inc. at 33.3%; the lowest is Regence BlueCross BlueShield of Utah at 14.8%.
What does Imperial Health Plan of the Southwest, Inc. deny most often in Utah?
Other reasons, 141 claims, 71.9% of this issuer's categorized denials, against 32.3% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.
How long do I have to appeal an Imperial Health Plan of the Southwest, Inc. denial in Utah?
Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Utah, Imperial Health Plan of the Southwest, Inc. included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.
Does appealing an Imperial Health Plan of the Southwest, Inc. denial in Utah cost anything?
The internal appeal to Imperial Health Plan of the Southwest, Inc. is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Utah can be charged more than that to file one.
Can Imperial Health Plan of the Southwest, Inc. ignore an external review decision in Utah?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law, which is what makes the zero external reviews recorded against 87 Imperial Health Plan of the Southwest, Inc. denials in Utah the striking number on this page.
The line on this page I would read twice is the one that says not one of Imperial Health Plan of the Southwest, Inc.'s 87 denials in Utah reached independent review. I am not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to me and I will correct the page.
, Andrew at Axion Labs · hello@getaxionlabs.comEverything you need for your Imperial Health Plan of the Southwest, Inc. appeal in Utah: 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.
The Imperial Health Plan of the Southwest, Inc. figures on this page, the 33.3% denial rate, the 87 denials and the 0 external reviews, are this issuer’s own reported rows in that file.
Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).