University of Utah Health Insurance Plans denied your claim. Here is your deadline.
Put in the date on your University of Utah Health Insurance Plans notice and get both federal deadlines as calendar dates.
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University of Utah Health Insurance Plans denied 171,878 of 911,638 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 17.3% of in-network claims, 1,967,874 of them, and 2,339 were appealed.
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
University of Utah Health Insurance Plans denied 18.9% of in-network claims in Utah, 171,878 claims out of 911,638.
Further down this page, after the free steps: the paid next step.
Insurance got denied, what to do next?
Those 171,878 denials are 8.7% of every in-network denial recorded in Utah in this release, which makes University of Utah Health Insurance Plans the 2nd largest source of denials of the 5 insurers reporting there. Spread across its 12 plans in the state that is about 14,323 denials per plan. 532 internal appeals were filed against those 171,878 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 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: 171,878 in-network claims were denied by University of Utah Health Insurance Plans 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 5 insurers reporting a denial rate in Utah, University of Utah Health Insurance Plans is the third highest at 18.9%. The highest in the state is 28.8% and the lowest is 13.5%.
- That is 3.2 percentage points above the 15.7% national average across this dataset, and 1.6 points above the Utah average of 17.3%.
- Behind the percentage: 911,638 in-network claims were processed under 12 plans in Utah, and 171,878 of them came back denied.
- For every 10,000 claims University of Utah Health Insurance Plans denied, about 31 came back as an internal appeal. The other 9,969 stopped at the letter.
- Of the internal appeals it did receive, University of Utah Health Insurance Plans overturned 27.07%, 144 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 benefit limit reached at 24% 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.
- University of Utah Health Insurance Plans accounts for 8.7% of every in-network claim denied in Utah in this file.
- By raw volume it is the 74th 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, 49,055 claims, 21.7% of its categorized denials.
- Third on its own list is administrative reason, 45,366 claims, 20.1% of what University of Utah Health Insurance Plans categorized in Utah. Between them the top three account for 65.8% of its categorized denials.
- Where University of Utah Health Insurance Plans differs most from the national mix is benefit limit reached: 24% of its categorized denials in Utah against 4.9% across the file.
- Read the other way round: 739,760 of those 911,638 in-network claims were paid, 81.1% of everything University of Utah Health Insurance Plans processed in Utah.
- Spread across the 12 plans it reports in Utah, that is about 14,323 denied claims per plan, on about 75,970 claims processed per plan.
- Its reason columns add up to 225,690 categorized rows against 171,878 denials, 131.3% 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 experimental or investigational, 1,693 claims, 0.8% of what University of Utah Health Insurance Plans categorized there.
- Against the file as a whole, this one record is 0.2% 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 University of Utah Health Insurance Plans records most often in Utah 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 University of Utah Health Insurance Plans 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. University of Utah Health Insurance Plans overturned 27.07% of the internal appeals it did receive, 144 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 |
|---|---|---|
| University of Utah Health Insurance Plans | 18.9% | , |
| Utah average | 17.3% | +1.6 pts |
| National average (this dataset) | 15.7% | +3.2 pts |
University of Utah Health Insurance Plans denies 3.2 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 University of Utah Health Insurance Plans) | 532 | 27.07% |
| External review (independent) | 0 | not reported |
The gap nobody escalated
171,878 claims denied. 532 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 University of Utah Health Insurance Plans letter, and by when. University of Utah Health Insurance Plans overturned 27.07% of the 532 internal appeals its Utah members filed against 171,878 denials, and not one of those Utah denials went on to the independent stage whose decision binds the plan, University of Utah Health Insurance Plans'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 University of Utah Health Insurance Plans 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 University of Utah Health Insurance Plans in Utah. One payment. No subscription. No cut of your claim.
University of Utah Health Insurance Plans inside Utah
Your denial did not happen in a national average. It happened in a state market, alongside 4 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Utah, the 5 insurers reporting in this file processed 11,373,974 in-network claims and denied 1,967,874 of them, a state denial rate of 17.3%. University of Utah Health Insurance Plans is one of those 5.
- That puts Utah 12th of 29 states by denial rate, 1.6 points above the 15.7% national average, before you get to what University of Utah Health Insurance Plans did inside it.
- Utah recorded 2,339 internal appeals against those denials: one appeal for every 841 claims the state's insurers refused. University of Utah Health Insurance Plans's own ratio is one for every 323.
- Independent external review was reached 3,028 times in the whole of Utah, once for every 650 denials, against one in 17,061 nationally. None of them came from University of Utah Health Insurance Plans's denials.
- Of the Utah external reviews that were filed, 476 were overturned, 15.7%. That percentage is measured on 3,028 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against University of Utah Health Insurance Plans.
- The reason Utah's insurers record most often is other reasons, 1,520,994 claims, 60.3% of the state's categorized denials. University of Utah Health Insurance Plans records benefit limit reached most often instead, which is the argument your letter will need to answer.
- The other insurers a Utah reader could have bought from run from 28.8% (Imperial Health Plan of the Southwest, Inc.) to 13.5% (Regence BlueCross BlueShield of Utah). University of Utah Health Insurance Plans at 18.9% sits between the two.
- Put the two together and University of Utah Health Insurance Plans is responsible for 8.7% of every in-network claim denied in Utah in this release, from 8% 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 University of Utah Health Insurance Plans'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 Utah page is free at /states/utah.
What University of Utah Health Insurance Plans denies most
The most common denial reason recorded for University of Utah Health Insurance Plans plans in Utah is benefit limit reached. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Benefit limit reached | 54,195 | 24% | 4.9% |
| Other reasons | 49,055 | 21.7% | 32.4% |
| Administrative reason | 45,366 | 20.1% | 17.2% |
| Service excluded from the plan | 32,191 | 14.3% | 13.4% |
| Referral required | 21,346 | 9.5% | 9.6% |
| Provider out of network | 10,172 | 4.5% | 9% |
| Member not covered | 8,754 | 3.9% | 7.9% |
| Not medically necessary | 2,918 | 1.3% | 5.5% |
| Experimental or investigational | 1,693 | 0.8% | 0.1% |
The last column is each reason's share of all categorized denials nationally, so you can see where University of Utah Health Insurance Plans'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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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: University of Utah Health Insurance Plans overturned 27.07% of the internal appeals it received.
Questions
Is University of Utah Health Insurance Plans's denial rate in Utah high?
18.9% 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 University of Utah Health Insurance Plans denial in Utah, and how many won?
532 internal appeals were filed against 171,878 denials, and 27.07% of them were overturned (144 claims). Not one went on to independent external review, the stage whose decision is binding on the plan.
How does University of Utah Health Insurance Plans compare with other insurers in Utah?
Of the 5 insurers in Utah with a reported denial rate, University of Utah Health Insurance Plans ranks 3 highest at 18.9%. The highest in Utah is Imperial Health Plan of the Southwest, Inc. at 28.8%; the lowest is Regence BlueCross BlueShield of Utah at 13.5%.
What does University of Utah Health Insurance Plans deny most often in Utah?
Benefit limit reached, 54,195 claims, 24% 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 University of Utah Health Insurance Plans 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, University of Utah Health Insurance Plans 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 University of Utah Health Insurance Plans denial in Utah cost anything?
The internal appeal to University of Utah Health Insurance Plans 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 University of Utah Health Insurance Plans 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 171,878 University of Utah Health Insurance Plans denials in Utah the striking number on this page.
The line on this page we would read twice is the one that says not one of University of Utah Health Insurance Plans's 171,878 denials in Utah 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 University of Utah Health Insurance Plans appeal in Utah: 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 University of Utah Health Insurance Plans figures on this page, the 18.9% denial rate, the 171,878 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).