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 48,655 of 298,634 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 12.1% of in-network claims, 1,188,325 of them, and 2,083 were appealed.
Network Health Plan denied 16.3% of in-network claims in Wisconsin, 48,655 claims out of 298,634.
Insurance got denied, what to do next?
Those 48,655 denials are 4.1% of every in-network denial recorded in Wisconsin in this release, which makes Network Health Plan the 8th largest source of denials of the 12 insurers reporting there. Spread across its 26 plans in the state that is about 1,871 denials per plan. 31 internal appeals were filed against those 48,655 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: 48,655 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 fourth highest at 16.3%. The highest in the state is 18.9% and the lowest is 6.5%.
- That is 2.4 percentage points below the 18.7% national average across this dataset, and 4.2 points above the Wisconsin average of 12.1%.
- Behind the percentage: 298,634 in-network claims were processed under 26 plans in Wisconsin, and 48,655 of them came back denied.
- For every 10,000 claims Network Health Plan denied, about 6 came back as an internal appeal. The other 9,994 stopped at the letter.
- Of the internal appeals it did receive, Network Health Plan overturned 38.71%, 12 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 32.8% are overturned.
- Its most-recorded denial reason is other reasons at 59.3% 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.
- Network Health Plan accounts for 4.1% of every in-network claim denied in Wisconsin in this file.
- By raw volume it is the 117th 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, 5,712 claims, 10.3% of its categorized denials.
- Third on its own list is member not covered, 5,415 claims, 9.7% of what Network Health Plan categorized in Wisconsin. Between them the top three account for 79.3% of its categorized denials.
- Where Network Health Plan differs most from the national mix is other reasons: 59.3% of its categorized denials in Wisconsin against 32.3% across the file.
- Read the other way round: 249,979 of those 298,634 in-network claims were paid, 83.7% of everything Network Health Plan processed in Wisconsin.
- Spread across the 26 plans it reports in Wisconsin, that is about 1,871 denied claims per plan, on about 11,486 claims processed per plan.
- Its reason columns add up to 55,619 categorized rows against 48,655 denials, 114.3% 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 Wisconsin is not medically necessary, 828 claims, 1.5% of what Network Health Plan categorized there.
- Against the file as a whole, this one record is 0.1% 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 Network Health Plan records most often in Wisconsin 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 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 38.71% of the internal appeals it did receive, 12 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 | 16.3% | , |
| Wisconsin average | 12.1% | +4.2 pts |
| National average (this dataset) | 18.7% | -2.4 pts |
Network Health Plan 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 Network Health Plan) | 31 | 38.71% |
| External review (independent) | 0 | 0% |
The gap nobody escalated
48,655 claims denied. 31 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 Network Health Plan letter, and by when. Network Health Plan overturned 38.71% of the 31 internal appeals its Wisconsin members filed against 48,655 denials, and not one of those Wisconsin denials went on to the independent stage whose decision binds the plan, Network Health Plan's own 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 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 9,824,576 in-network claims and denied 1,188,325 of them, a state denial rate of 12.1%. Network Health Plan is one of those 12.
- That puts Wisconsin 25th of 30 states by denial rate, 6.6 points below the 18.7% national average, before you get to what Network Health Plan did inside it.
- Wisconsin recorded 2,083 internal appeals against those denials: one appeal for every 570 claims the state's insurers refused. Network Health Plan's own ratio is one for every 1,570.
- Not one denial in Wisconsin reached independent external review in the reported year, not Network Health Plan'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 Wisconsin's insurers record most often is other reasons, 363,275 claims, 39.5% of the state's categorized denials. Network Health Plan records the same one most often, so your letter is likely to say it too.
- The other insurers a Wisconsin reader could have bought from run from 18.9% (Security Health Plan of Wisconsin, Inc.) to 6.5% (HealthPartners Insurance Company). Network Health Plan at 16.3% sits between the two.
- Put the two together and Network Health Plan is responsible for 4.1% of every in-network claim denied in Wisconsin in this release, from 3% 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 (PY2026 release, PY2024 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 other reasons. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Other reasons | 32,989 | 59.3% | 32.3% |
| Referral required | 5,712 | 10.3% | 8.4% |
| Member not covered | 5,415 | 9.7% | 6.6% |
| Benefit limit reached | 4,881 | 8.8% | 4.2% |
| Service excluded from the plan | 3,067 | 5.5% | 11.6% |
| Provider out of network | 1,828 | 3.3% | 9.8% |
| Administrative reason | 899 | 1.6% | 22.5% |
| Not medically necessary | 828 | 1.5% | 4.6% |
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 →
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 38.71% of the internal appeals it received.
Questions
Is Network Health Plan's denial rate in Wisconsin high?
16.3% against a national average of 18.7% 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 Network Health Plan denial in Wisconsin, and how many won?
31 internal appeals were filed against 48,655 denials, and 38.71% of them were overturned (12 claims). Not one went on to independent external review, the stage whose decision is binding on the plan.
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 4 highest at 16.3%. The highest in Wisconsin is Security Health Plan of Wisconsin, Inc. at 18.9%; the lowest is HealthPartners Insurance Company at 6.5%.
What does Network Health Plan deny most often in Wisconsin?
Other reasons, 32,989 claims, 59.3% 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 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, which is what makes the zero external reviews recorded against 48,655 Network Health Plan denials in Wisconsin the striking number on this page.
The line on this page I would read twice is the one that says not one of Network Health Plan's 48,655 denials in Wisconsin 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 Network Health Plan appeal in Wisconsin: 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 Network Health Plan figures on this page, the 16.3% denial rate, the 48,655 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).