Network denied your claim in Wisconsin. Here is your deadline.
Put in the date on your Network Health Plan notice and get both federal deadlines as calendar dates.
Free, for a Network Health Plan denial in Wisconsin, 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.
Network Health Plan denied 117,572 of 689,952 in-network claims in Wisconsin; every one of those denials had these same two dates on it. Across Wisconsin as a whole the insurers in this file denied 15.4% of in-network claims, 1,893,070 of them, and 2,216 were appealed.
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
Network Health Plan denied 17% of in-network claims in Wisconsin, 117,572 claims out of 689,952.
Further down this page, after the free steps: the paid next step.
Insurance got denied, what to do next?
Those 117,572 denials are 6.2% of every in-network denial recorded in Wisconsin in this release, which makes Network Health Plan the 6th largest source of denials of the 12 insurers reporting there. Spread across its 26 plans in the state that is about 4,522 denials per plan. 57 internal appeals were filed against those 117,572 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 Wisconsin 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: 117,572 in-network claims were denied by Network Health Plan in Wisconsin 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 12 insurers reporting a denial rate in Wisconsin, Network Health Plan is the third highest at 17%. The highest in the state is 24.5% and the lowest is 6.5%.
- That is 1.3 percentage points above the 15.7% national average across this dataset, and 1.6 points above the Wisconsin average of 15.4%.
- Behind the percentage: 689,952 in-network claims were processed under 26 plans in Wisconsin, and 117,572 of them came back denied.
- For every 10,000 claims Network Health Plan denied, about 5 came back as an internal appeal. The other 9,995 stopped at the letter.
- Of the internal appeals it did receive, Network Health Plan overturned 57.89%, 33 claims that started life as a no.
- Its most-recorded denial reason is benefit limit reached at 30.4% of its categorized denials, against 4.9% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- Network Health Plan accounts for 6.2% of every in-network claim denied in Wisconsin in this file.
- By raw volume it is the 80th largest source of denials among the 135 insurer-state records in the file that report one.
- After that, its second-most-recorded reason is other reasons, 43,891 claims, 29.9% of its categorized denials.
- Third on its own list is administrative reason, 26,055 claims, 17.7% of what Network Health Plan categorized in Wisconsin. Between them the top three account for 78% of its categorized denials.
- Where Network Health Plan differs most from the national mix is benefit limit reached: 30.4% of its categorized denials in Wisconsin against 4.9% across the file.
- Read the other way round: 572,380 of those 689,952 in-network claims were paid, 83% of everything Network Health Plan processed in Wisconsin.
- Spread across the 26 plans it reports in Wisconsin, that is about 4,522 denied claims per plan, on about 26,537 claims processed per plan.
- Its reason columns add up to 146,972 categorized rows against 117,572 denials, 125% 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 Wisconsin is experimental or investigational, 11 claims, 0% of what Network Health Plan 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 Network Health Plan records most often in Wisconsin is benefit limit reached, 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 Network Health Plan in Wisconsin 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. Network Health Plan overturned 57.89% of the internal appeals it did receive, 33 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 |
|---|---|---|
| Network Health Plan | 17% | , |
| Wisconsin average | 15.4% | +1.6 pts |
| National average (this dataset) | 15.7% | +1.3 pts |
Network Health Plan denies 1.3 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 Network Health Plan) | 57 | 57.89% |
| External review (independent) | not reported | not reported |
What that record means for your own Network Health Plan letter, and by when. Network Health Plan overturned 57.89% of the 57 internal appeals its Wisconsin members filed against 117,572 denials, and the Wisconsin escalation count for Network Health Plan is the figure this page names as absent at the top, so how many of those denials went on to the independent stage is not something this page can tell you, Network Health Plan'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 Network Health Plan 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 Network Health Plan in Wisconsin. One payment. No subscription. No cut of your claim.
Network Health Plan inside Wisconsin
Your denial did not happen in a national average. It happened in a state market, alongside 11 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Wisconsin, the 12 insurers reporting in this file processed 12,326,174 in-network claims and denied 1,893,070 of them, a state denial rate of 15.4%. Network Health Plan is one of those 12.
- That puts Wisconsin 18th of 29 states by denial rate, 0.3 points below the 15.7% national average, before you get to what Network Health Plan did inside it.
- Wisconsin recorded 2,216 internal appeals against those denials: one appeal for every 854 claims the state's insurers refused. Network Health Plan's own ratio is one for every 2,063.
- Independent external review was reached 12 times in the whole of Wisconsin, once for every 157,756 denials, against one in 17,061 nationally. How many came from Network Health Plan's denials is not on the record, that is the Wisconsin figure this page names as absent at the top and sources at the foot.
- Of the Wisconsin external reviews that were filed, 0 were overturned, 0%. That percentage is measured on 12 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Network Health Plan.
- The reason Wisconsin's insurers record most often is other reasons, 687,434 claims, 34.3% of the state's categorized denials. Network Health Plan records benefit limit reached most often instead, which is the argument your letter will need to answer.
- The other insurers a Wisconsin reader could have bought from run from 24.5% (Common Ground Healthcare Cooperative) to 6.5% (HealthPartners Insurance Company). Network Health Plan at 17% sits between the two.
- Put the two together and Network Health Plan is responsible for 6.2% of every in-network claim denied in Wisconsin in this release, from 5.6% of the claims the state's insurers processed.
- Every Wisconsin figure in this section is that state's own row in the same federal file Network Health Plan'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 Wisconsin page is free at /states/wisconsin.
What Network Health Plan denies most
The most common denial reason recorded for Network Health Plan plans in Wisconsin is benefit limit reached. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Benefit limit reached | 44,732 | 30.4% | 4.9% |
| Other reasons | 43,891 | 29.9% | 32.4% |
| Administrative reason | 26,055 | 17.7% | 17.2% |
| Service excluded from the plan | 10,337 | 7% | 13.4% |
| Member not covered | 10,037 | 6.8% | 7.9% |
| Referral required | 5,550 | 3.8% | 9.6% |
| Provider out of network | 4,878 | 3.3% | 9% |
| Not medically necessary | 1,481 | 1% | 5.5% |
| Experimental or investigational | 11 | 0% | 0.1% |
The last column is each reason's share of all categorized denials nationally, so you can see where Network Health Plan's mix in Wisconsin 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: Network Health Plan overturned 57.89% of the internal appeals it received.
Questions
Is Network Health Plan's denial rate in Wisconsin high?
17% against a national average of 15.7% 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 a Network Health Plan denial in Wisconsin, and how many won?
57 internal appeals were filed against 117,572 denials, and 57.89% of them were overturned (33 claims). How many went on to independent external review is not on the record for Network Health Plan in Wisconsin, that is the absence stated at the top of this page and sourced at the foot of it.
How does Network Health Plan compare with other insurers in Wisconsin?
Of the 12 insurers in Wisconsin with a reported denial rate, Network Health Plan ranks 3 highest at 17%. The highest in Wisconsin is Common Ground Healthcare Cooperative at 24.5%; the lowest is HealthPartners Insurance Company at 6.5%.
What does Network Health Plan deny most often in Wisconsin?
Benefit limit reached, 44,732 claims, 30.4% of this issuer's categorized denials, against 4.9% 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 Network Health Plan denial in Wisconsin?
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 Wisconsin, Network Health Plan 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 Network Health Plan denial in Wisconsin cost anything?
The internal appeal to Network Health Plan 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 Wisconsin can be charged more than that to file one.
Can Network Health Plan ignore an external review decision in Wisconsin?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law. The count is the one this page names as absent for Network Health Plan in Wisconsin, so none is printed for it, an absent figure is not a count of none.
Network Health Plan sits at 17% in Wisconsin against 15.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. 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 Network Health Plan appeal in Wisconsin: 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 Network Health Plan figures on this page, the 17% denial rate, the 117,572 denials, are this issuer’s own reported rows in that file. CMS did not report an external-review figure for Network Health Plan in Wisconsin in the plan-year 2027 release of the Transparency in Coverage file, which is why no external-review count appears above.
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).