Montana Health Cooperative denied your claim. Here is your deadline.
Put in the date on your Montana Health Cooperative notice and get both federal deadlines as calendar dates.
Free, for a Montana Health Cooperative denial in Montana, 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.
Montana Health Cooperative denied 103,510 of 858,133 in-network claims in Montana; every one of those denials had these same two dates on it. Across Montana as a whole the insurers in this file denied 12.7% of in-network claims, 323,019 of them, and 418 were appealed.
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
Montana Health Cooperative denied 12.1% of in-network claims in Montana, 103,510 claims out of 858,133.
Further down this page, after the free steps: the paid next step.
Insurance got denied, what to do next?
Those 103,510 denials are 32% of every in-network denial recorded in Montana in this release, which makes Montana Health Cooperative the 2nd largest source of denials of the 2 insurers reporting there. Spread across its 13 plans in the state that is about 7,962 denials per plan. 26 internal appeals were filed against those 103,510 denials. 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 Montana 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: 103,510 in-network claims were denied by Montana Health Cooperative in Montana 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 2 insurers reporting a denial rate in Montana, Montana Health Cooperative is the second highest at 12.1%. The highest in the state is 13.1% and the lowest is 12.1%.
- That is 3.6 percentage points below the 15.7% national average across this dataset, and 0.6 points below the Montana average of 12.7%.
- Behind the percentage: 858,133 in-network claims were processed under 13 plans in Montana, and 103,510 of them came back denied.
- For every 10,000 claims Montana Health Cooperative denied, about 3 came back as an internal appeal. The other 9,997 stopped at the letter.
- Of the internal appeals it did receive, Montana Health Cooperative overturned 57.69%, 15 claims that started life as a no.
- Not one of those denials reached independent external review, the stage whose decision the plan is required by law to accept, and where nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) are overturned.
- Its most-recorded denial reason is other reasons at 83.9% of its categorized denials, against 32.4% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- Montana Health Cooperative accounts for 32% of every in-network claim denied in Montana in this file.
- By raw volume it is the 84th largest source of denials among the 135 insurer-state records in the file that report one.
- After that, its second-most-recorded reason is referral required, 7,125 claims, 14.4% of its categorized denials.
- Third on its own list is service excluded from the plan, 773 claims, 1.6% of what Montana Health Cooperative categorized in Montana. Between them the top three account for 99.9% of its categorized denials.
- Where Montana Health Cooperative differs most from the national mix is other reasons: 83.9% of its categorized denials in Montana against 32.4% across the file.
- Read the other way round: 754,623 of those 858,133 in-network claims were paid, 87.9% of everything Montana Health Cooperative processed in Montana.
- Spread across the 13 plans it reports in Montana, that is about 7,962 denied claims per plan, on about 66,010 claims processed per plan.
- Its reason columns add up to 49,469 categorized rows against 103,510 denials, 47.8% 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 Montana is member not covered, 69 claims, 0.1% of what Montana Health Cooperative categorized there.
- Against the file as a whole, this one record is 0.1% of the 83,907,852 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The reason Montana Health Cooperative records most often in Montana 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 Montana Health Cooperative in Montana 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. Montana Health Cooperative overturned 57.69% of the internal appeals it did receive, 15 claims, so the stage you are about to start is not decorative.
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 |
|---|---|---|
| Montana Health Cooperative | 12.1% | , |
| Montana average | 12.7% | -0.6 pts |
| National average (this dataset) | 15.7% | -3.6 pts |
Montana Health Cooperative sits at or below 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 Montana Health Cooperative) | 26 | 57.69% |
| External review (independent) | 0 | not reported |
The gap nobody escalated
103,510 claims denied. 26 internal appeals filed. None reached independent external review. Nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) 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 Montana Health Cooperative letter, and by when. Montana Health Cooperative overturned 57.69% of the 26 internal appeals its Montana members filed against 103,510 denials, and not one of those Montana denials went on to the independent stage whose decision binds the plan, Montana Health Cooperative's own rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 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 65 calendar days from the date of its notice (CMS, 42 CFR 422.582(b)) and Medicaid managed care 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 Montana Health Cooperative 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 Montana Health Cooperative in Montana. One payment. No subscription. No cut of your claim.
Montana Health Cooperative inside Montana
Your denial did not happen in a national average. It happened in a state market, alongside 1 other insurer reporting into the same federal file, and these are that market's own figures.
- Across the whole of Montana, the 2 insurers reporting in this file processed 2,539,614 in-network claims and denied 323,019 of them, a state denial rate of 12.7%. Montana Health Cooperative is one of those 2.
- That puts Montana 22th of 29 states by denial rate, 3 points below the 15.7% national average, before you get to what Montana Health Cooperative did inside it.
- Montana recorded 418 internal appeals against those denials: one appeal for every 773 claims the state's insurers refused. Montana Health Cooperative's own ratio is one for every 3,981.
- Not one denial in Montana reached independent external review in the reported year, not Montana Health Cooperative's and not any other insurer's in the state. That is the stage whose decision the plan is required by law to accept.
- The reason Montana's insurers record most often is other reasons, 156,716 claims, 47.6% of the state's categorized denials. Montana Health Cooperative records the same one most often, so your letter is likely to say it too.
- The other insurers a Montana reader could have bought from run from 13.1% (Blue Cross and Blue Shield of Montana) to 13.1% (Blue Cross and Blue Shield of Montana). Montana Health Cooperative at 12.1% sits below all of them.
- Put the two together and Montana Health Cooperative is responsible for 32% of every in-network claim denied in Montana in this release, from 33.8% of the claims the state's insurers processed.
- Every Montana figure in this section is that state's own row in the same federal file Montana Health Cooperative's numbers above come from, CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain, and the full Montana page is free at /states/montana.
What Montana Health Cooperative denies most
The most common denial reason recorded for Montana Health Cooperative plans in Montana is other reasons. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Other reasons | 41,502 | 83.9% | 32.4% |
| Referral required | 7,125 | 14.4% | 9.6% |
| Service excluded from the plan | 773 | 1.6% | 13.4% |
| Member not covered | 69 | 0.1% | 7.9% |
The last column is each reason's share of all categorized denials nationally, so you can see where Montana Health Cooperative's mix in Montana 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.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
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. For what it is worth on this page specifically: Montana Health Cooperative overturned 57.69% of the internal appeals it received.
Questions
Is Montana Health Cooperative's denial rate in Montana high?
12.1% against a national average of 15.7% across the plans in this dataset. It is at or below average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed a Montana Health Cooperative denial in Montana, and how many won?
26 internal appeals were filed against 103,510 denials, and 57.69% of them were overturned (15 claims). Not one went on to independent external review, the stage whose decision is binding on the plan.
How does Montana Health Cooperative compare with other insurers in Montana?
Of the 2 insurers in Montana with a reported denial rate, Montana Health Cooperative ranks 2 highest at 12.1%. The highest in Montana is Blue Cross and Blue Shield of Montana at 13.1%; the lowest is Montana Health Cooperative at 12.1%.
What does Montana Health Cooperative deny most often in Montana?
Other reasons, 41,502 claims, 83.9% of this issuer's categorized denials, against 32.4% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.
How long do I have to appeal a Montana Health Cooperative denial in Montana?
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 Montana, Montana Health Cooperative 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 a Montana Health Cooperative denial in Montana cost anything?
The internal appeal to Montana Health Cooperative 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 Montana can be charged more than that to file one.
Can Montana Health Cooperative ignore an external review decision in Montana?
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 103,510 Montana Health Cooperative denials in Montana the striking number on this page.
The line on this page we would read twice is the one that says not one of Montana Health Cooperative's 103,510 denials in Montana reached independent review. We are 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 us and we will correct the page.
Axion Labs · hello@getaxionlabs.comEverything you need for your Montana Health Cooperative appeal in Montana: your two deadlines, the argument that fits your denial reason, the letters, a brief for your doctor on what the reviewer checks, 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 Montana Health Cooperative figures on this page, the 12.1% denial rate, the 103,510 denials and the 0 external reviews, are this issuer’s own reported rows in that file.
Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 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).