USAble HMO denied your claim in Arkansas. Here is your deadline.
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USAble HMO, Inc. denied 283,918 of 1,787,131 in-network claims in Arkansas; every one of those denials had these same two dates on it. Across Arkansas as a whole the insurers in this file denied 13.5% of in-network claims, 1,437,735 of them, and 9,645 were appealed.
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USAble HMO, Inc. denied 15.9% of in-network claims in Arkansas, 283,918 claims out of 1,787,131.
Further down this page, after the free steps: the paid next step.
Insurance got denied, what to do next?
Those 283,918 denials are 19.7% of every in-network denial recorded in Arkansas in this release, which makes USAble HMO, Inc. the 4th largest source of denials of the 4 insurers reporting there. Spread across its 7 plans in the state that is about 40,560 denials per plan. 1,639 internal appeals were filed against those 283,918 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 Arkansas 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: 283,918 in-network claims were denied by USAble HMO, Inc. in Arkansas 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 4 insurers reporting a denial rate in Arkansas, USAble HMO, Inc. is the second highest at 15.9%. The highest in the state is 16.5% and the lowest is 8.8%.
- That is 0.2 percentage points above the 15.7% national average across this dataset, and 2.4 points above the Arkansas average of 13.5%.
- Behind the percentage: 1,787,131 in-network claims were processed under 7 plans in Arkansas, and 283,918 of them came back denied.
- For every 10,000 claims USAble HMO, Inc. denied, about 58 came back as an internal appeal. The other 9,942 stopped at the letter.
- Of the internal appeals it did receive, USAble HMO, Inc. overturned 24.41%, 400 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 36.3% 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.
- USAble HMO, Inc. accounts for 19.7% of every in-network claim denied in Arkansas in this file.
- By raw volume it is the 55th largest source of denials among the 135 insurer-state records in the file that report one.
- After that, its second-most-recorded reason is administrative reason, 70,269 claims, 23.1% of its categorized denials.
- Third on its own list is other reasons, 59,354 claims, 19.5% of what USAble HMO, Inc. categorized in Arkansas. Between them the top three account for 78.9% of its categorized denials.
- Where USAble HMO, Inc. differs most from the national mix is benefit limit reached: 36.3% of its categorized denials in Arkansas against 4.9% across the file.
- Read the other way round: 1,503,213 of those 1,787,131 in-network claims were paid, 84.1% of everything USAble HMO, Inc. processed in Arkansas.
- Spread across the 7 plans it reports in Arkansas, that is about 40,560 denied claims per plan, on about 255,304 claims processed per plan.
- Its reason columns add up to 304,642 categorized rows against 283,918 denials, 107.3% 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 Arkansas is not medically necessary, 79 claims, 0% of what USAble HMO, Inc. categorized there.
- Against the file as a whole, this one record is 0.3% 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 USAble HMO, Inc. records most often in Arkansas 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 USAble HMO, Inc. in Arkansas 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. USAble HMO, Inc. overturned 24.41% of the internal appeals it did receive, 400 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 |
|---|---|---|
| USAble HMO, Inc. | 15.9% | , |
| Arkansas average | 13.5% | +2.4 pts |
| National average (this dataset) | 15.7% | +0.2 pts |
USAble HMO, Inc. denies 0.2 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 USAble HMO, Inc.) | 1,639 | 24.41% |
| External review (independent) | 0 | not reported |
The gap nobody escalated
283,918 claims denied. 1,639 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 USAble HMO, Inc. letter, and by when. USAble HMO, Inc. overturned 24.41% of the 1,639 internal appeals its Arkansas members filed against 283,918 denials, and not one of those Arkansas denials went on to the independent stage whose decision binds the plan, USAble HMO, Inc.'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 USAble HMO, 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 USAble HMO, Inc. in Arkansas. One payment. No subscription. No cut of your claim.
USAble HMO, Inc. inside Arkansas
Your denial did not happen in a national average. It happened in a state market, alongside 3 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Arkansas, the 4 insurers reporting in this file processed 10,654,143 in-network claims and denied 1,437,735 of them, a state denial rate of 13.5%. USAble HMO, Inc. is one of those 4.
- That puts Arkansas 19th of 29 states by denial rate, 2.2 points below the 15.7% national average, before you get to what USAble HMO, Inc. did inside it.
- Arkansas recorded 9,645 internal appeals against those denials: one appeal for every 149 claims the state's insurers refused. USAble HMO, Inc.'s own ratio is one for every 173.
- Not one denial in Arkansas reached independent external review in the reported year, not USAble HMO, Inc.'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 Arkansas's insurers record most often is benefit limit reached, 531,270 claims, 36.2% of the state's categorized denials. USAble HMO, Inc. records the same one most often, so your letter is likely to say it too.
- The other insurers an Arkansas reader could have bought from run from 16.5% (HMO Partners, Inc.) to 8.8% (QCA Health Plan, Inc.). USAble HMO, Inc. at 15.9% sits between the two.
- Put the two together and USAble HMO, Inc. is responsible for 19.7% of every in-network claim denied in Arkansas in this release, from 16.8% of the claims the state's insurers processed.
- Every Arkansas figure in this section is that state's own row in the same federal file USAble HMO, Inc.'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 Arkansas page is free at /states/arkansas.
What USAble HMO, Inc. denies most
The most common denial reason recorded for USAble HMO, Inc. plans in Arkansas is benefit limit reached. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Benefit limit reached | 110,668 | 36.3% | 4.9% |
| Administrative reason | 70,269 | 23.1% | 17.2% |
| Other reasons | 59,354 | 19.5% | 32.4% |
| Member not covered | 39,618 | 13% | 7.9% |
| Referral required | 23,891 | 7.8% | 9.6% |
| Service excluded from the plan | 763 | 0.3% | 13.4% |
| Not medically necessary | 79 | 0% | 5.5% |
The last column is each reason's share of all categorized denials nationally, so you can see where USAble HMO, Inc.'s mix in Arkansas 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: USAble HMO, Inc. overturned 24.41% of the internal appeals it received.
Questions
Is USAble HMO, Inc.'s denial rate in Arkansas high?
15.9% 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 USAble HMO, Inc. denial in Arkansas, and how many won?
1,639 internal appeals were filed against 283,918 denials, and 24.41% of them were overturned (400 claims). Not one went on to independent external review, the stage whose decision is binding on the plan.
How does USAble HMO, Inc. compare with other insurers in Arkansas?
Of the 4 insurers in Arkansas with a reported denial rate, USAble HMO, Inc. ranks 2 highest at 15.9%. The highest in Arkansas is HMO Partners, Inc. at 16.5%; the lowest is QCA Health Plan, Inc. at 8.8%.
What does USAble HMO, Inc. deny most often in Arkansas?
Benefit limit reached, 110,668 claims, 36.3% 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 USAble HMO, Inc. denial in Arkansas?
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 Arkansas, USAble HMO, 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 a USAble HMO, Inc. denial in Arkansas cost anything?
The internal appeal to USAble HMO, 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 Arkansas can be charged more than that to file one.
Can USAble HMO, Inc. ignore an external review decision in Arkansas?
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 283,918 USAble HMO, Inc. denials in Arkansas the striking number on this page.
The line on this page we would read twice is the one that says not one of USAble HMO, Inc.'s 283,918 denials in Arkansas 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 USAble HMO, Inc. appeal in Arkansas: 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 USAble HMO, Inc. figures on this page, the 15.9% denial rate, the 283,918 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).