---
title: "USAble AR appeal form and deadline"
url: "https://denialfacts.com/insurers/usable-mutual-insurance-company--ar"
publisher: "Axion Labs — Denial Facts"
checked: "2026-11-04"
dataset_fixity: "sha256-cda2f9b89c8dde2a74989a35dbe7c0d08ff35dac5456484dc1c03c1b181a67b6"
---

# USAble denied your claim in Arkansas. Here is your deadline.

Denied by USAble in Arkansas? Your two federal appeal deadlines dated from your notice, a free letter, and its 15% denial rate in the federal file.

## Figures

| Figure | Value |
| --- | --- |
| In-network denial rate | 15% |
| Claims denied | 570,178 |
| Plans in Arkansas | 7 |
| Internal appeals filed | 5,782 |
| Internal overturn rate | 28.23% |
| In-network claims received | 3,803,008 |
| External reviews filed | not reported |
| External overturn rate | not reported |
| National denial rate | 15.7% |

## External-review route

**State-run process.** Arkansas runs its own external review process meeting the federal standards, so an independent review there is handled through the state program rather than the federal one. This route is the one for insured plans, Marketplace, individual, and employer plans where an insurance company carries the risk. If your coverage is through a job and the employer pays the claims itself (a self-funded or self-insured plan, which is 63% of covered workers), the state process does not apply to you whatever your state operates, and your external review goes through the federal process instead. Your denial letter names your route; if it does not, ask your plan in writing whether the plan is self-funded.

## Denials by reason

| Reason | Claims | Share of this insurer's categorized denials |
| --- | --- | --- |
| Benefit limit reached | 340,987 | 44.5% |
| Administrative reason | 204,829 | 26.7% |
| Other reasons | 94,221 | 12.3% |
| Referral required | 71,660 | 9.4% |
| Member not covered | 52,813 | 6.9% |
| Service excluded from the plan | 1,442 | 0.2% |
| Not medically necessary | 201 | 0% |
| Provider out of network | 28 | 0% |

## USAble in Arkansas, at the top of the page

Arkansas

Your two dates, free

Date on your denial notice

Who pays your claims?

A job, an insurance company pays the claims

A job, my employer pays the claims itself (self-funded)

A job, I do not know which

Marketplace / individual plan I bought myself

Medicare, Medicaid, TRICARE, VA or IHS

Which state?

The reason your letter gives

I'm not sure, I'll paste the sentence later

Not medically necessary
Provider out of network
Service excluded from the plan
Experimental or investigational
Referral required
Benefit limit reached
Member not covered
Administrative reason
Other reasons

Show my two dates, free

Put in the date on your USAble Mutual Insurance Company notice and get both federal deadlines as calendar dates.

Free, for a USAble Mutual Insurance Company denial in Arkansas, 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.

USAble Mutual Insurance Company denied 570,178 of 3,803,008 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.

Or let the [$29 Appeal Kit](/appeal-kit) date each step and write the claim-file and external-review requests.

USAble Mutual Insurance Company denied 15% of in-network claims in Arkansas, 570,178 claims out of 3,803,008.

By [Axion Labs](/about) · August 19, 2026, updated November 4, 2026

Further down this page, after the free steps: the paid next step .

Insurance got denied, what to do next?

We hear this most. [r/HealthInsurance, thread title](https://www.reddit.com/r/HealthInsurance/comments/1rdxwvi/insurance_got_denied_what_to_do_next/) , read September 3, 2026.

The number nobody else publishes, and here it is missing. CMS publishes no external-review figure for USAble Mutual Insurance Company in Arkansas, so nobody, including the regulator, can say whether anyone ever got that far. We print no number rather than reading an absence as a zero. Nationally, 4,918 of 83,907,852 denials reached that stage, one in every 17,061, and 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of those were overturned.

Those 570,178 denials are 39.7% of every in-network denial recorded in Arkansas in this release, which makes USAble Mutual Insurance Company the 1st largest source of denials of the 4 insurers reporting there. Spread across its 7 plans in the state that is about 81,454 denials per plan. 5,782 internal appeals were filed against those 570,178 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.

The clock your letter has to describe, in actual dates

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](https://www.ecfr.gov/current/title-29/section-2560.503-1) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) ) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) ), in plain English at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/internal-appeals/) , 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.

Data verified November 4, 2026 · CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain

You are not alone, and here is the measured version of that sentence: 570,178 in-network claims were denied by USAble Mutual Insurance Company 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 Mutual Insurance Company is the third highest at 15%. The highest in the state is 16.5% and the lowest is 8.8%.

- That is 0.7 percentage points below the 15.7% national average across this dataset, and 1.5 points above the Arkansas average of 13.5%.

- Behind the percentage: 3,803,008 in-network claims were processed under 7 plans in Arkansas, and 570,178 of them came back denied.

- For every 10,000 claims USAble Mutual Insurance Company denied, about 101 came back as an internal appeal. The other 9,899 stopped at the letter.

- Of the internal appeals it did receive, USAble Mutual Insurance Company overturned 28.23% , 1,632 claims that started life as a no.

- Its most-recorded denial reason is benefit limit reached at 44.5% 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 Mutual Insurance Company accounts for 39.7% of every in-network claim denied in Arkansas in this file.

- By raw volume it is the 35th 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](/denial-reasons/administrative) , 204,829 claims, 26.7% of its categorized denials.

- Third on its own list is [other reasons](/denial-reasons/other) , 94,221 claims, 12.3% of what USAble Mutual Insurance Company categorized in Arkansas. Between them the top three account for 83.5% of its categorized denials.

- Where USAble Mutual Insurance Company differs most from the national mix is [benefit limit reached](/denial-reasons/benefit-limit-reached) : 44.5% of its categorized denials in Arkansas against 4.9% across the file.

- Read the other way round: 3,232,830 of those 3,803,008 in-network claims were paid, 85% of everything USAble Mutual Insurance Company processed in Arkansas.

- Spread across the 7 plans it reports in Arkansas, that is about 81,454 denied claims per plan, on about 543,287 claims processed per plan.

- Its reason columns add up to 766,181 categorized rows against 570,178 denials, 134.4% 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 [provider out of network](/denial-reasons/out-of-network) , 28 claims, 0% of what USAble Mutual Insurance Company categorized there.

- Against the file as a whole, this one record is 0.7% of the 83,907,852 in-network claim denials reported by every issuer in it.

What to do tonight

- Find the reason code on your denial letter. The reason USAble Mutual Insurance Company 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 Mutual Insurance Company in Arkansas for the clinical criteria they judged you against. Under [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-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 Mutual Insurance Company overturned 28.23% of the internal appeals it did receive, 1,632 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.

15%

In-network denial rate

570,178

Claims denied

7

Plans in Arkansas

5,782

Internal appeals filed

28.23%

Internal overturn rate

## How that compares

| Denial rate | Rate | Difference |
| --- | --- | --- |
| USAble Mutual Insurance Company | 15% | , |
| Arkansas average | 13.5% | +1.5 pts |
| National average (this dataset) | 15.7% | -0.7 pts |

USAble Mutual Insurance Company 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 USAble Mutual Insurance Company) | 5,782 | 28.23% |
| External review (independent) | not reported | not reported |

Read the table for what it is: the external-review row above shows a dash, which means not reported and not zero, the Arkansas absence this page states once at the top for USAble Mutual Insurance Company and sources once at the foot. External review is free to you and the insurer must follow the decision, whatever this file does or does not record about it.

What that record means for your own USAble Mutual Insurance Company letter, and by when. USAble Mutual Insurance Company overturned 28.23% of the 5,782 internal appeals its Arkansas members filed against 570,178 denials, and the Arkansas escalation count for USAble Mutual Insurance Company 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, USAble Mutual Insurance Company's own rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 2026 ( [data.healthcare.gov](https://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)](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) , carried onto individual-market coverage by [45 CFR 147.136(b)(3)(i)](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) ), while Medicare Advantage gives you 65 calendar days from the date of its notice ( [CMS](https://www.cms.gov/medicare/appeals-grievances/managed-care/reconsideration-advantage-health-plan-part-c) , [42 CFR 422.582(b)](https://www.ecfr.gov/current/title-42/section-422.582) ) and Medicaid managed care 60 calendar days from the date on the notice ( [42 CFR 438.402(c)(2)(ii)](https://www.ecfr.gov/current/title-42/section-438.402) ), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your USAble Mutual Insurance Company notice and file well inside whichever of those windows is yours. The free steps are above; the [$29 kit](/appeal-kit) is the same clock with the letters pre-filled for USAble Mutual Insurance Company in Arkansas. One payment. No subscription. No cut of your claim.

## USAble Mutual Insurance Company 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 Mutual Insurance Company 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 Mutual Insurance Company did inside it.

- Arkansas recorded 9,645 internal appeals against those denials: one appeal for every 149 claims the state's insurers refused. USAble Mutual Insurance Company's own ratio is one for every 99.

- Not one denial in Arkansas reached independent external review in the reported year, not USAble Mutual Insurance Company'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](/denial-reasons/benefit-limit-reached) , 531,270 claims, 36.2% of the state's categorized denials. USAble Mutual Insurance Company 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.](/insurers/hmo-partners-inc--ar) ) to 8.8% ( [QCA Health Plan, Inc.](/insurers/qca-health-plan-inc--ar) ). USAble Mutual Insurance Company at 15% sits between the two.

- Put the two together and USAble Mutual Insurance Company is responsible for 39.7% of every in-network claim denied in Arkansas in this release, from 35.7% 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 Mutual Insurance Company's numbers above come from, [CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain](https://data.healthcare.gov/) , and the full Arkansas page is free at [/states/arkansas](/states/arkansas) .

## What USAble Mutual Insurance Company denies most

The most common denial reason recorded for USAble Mutual Insurance Company plans in Arkansas is benefit limit reached . [How that denial is beaten →](/denial-reasons/benefit-limit-reached)

| Denial reason | Claims | Share | National share |
| --- | --- | --- | --- |
| Benefit limit reached | 340,987 | 44.5% | 4.9% |
| Administrative reason | 204,829 | 26.7% | 17.2% |
| Other reasons | 94,221 | 12.3% | 32.4% |
| Referral required | 71,660 | 9.4% | 9.6% |
| Member not covered | 52,813 | 6.9% | 7.9% |
| Service excluded from the plan | 1,442 | 0.2% | 13.4% |
| Not medically necessary | 201 | 0% | 5.5% |
| Provider out of network | 28 | 0% | 9% |

The last column is each reason's share of all categorized denials nationally, so you can see where USAble Mutual Insurance Company'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.

Work out your two deadlines

Put the date from your notice in and get the two calendar dates, with the days remaining.

Date on your denial notice

Which denial is this?

First denial (I have not appealed yet)

Final internal denial (my appeal was refused)

Show my deadlines

Runs entirely in your browser, the date you type is never sent to us and never stored. [Open the full calculator →](/appeal-deadline-calculator)

Or let the [$29 Appeal Kit](/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](/how-to-appeal) . For what it is worth on this page specifically: USAble Mutual Insurance Company overturned 28.23% of the internal appeals it received.

## Questions

##### Is USAble Mutual Insurance Company's denial rate in Arkansas high?

15% 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 USAble Mutual Insurance Company denial in Arkansas, and how many won?

5,782 internal appeals were filed against 570,178 denials, and 28.23% of them were overturned (1,632 claims). How many went on to independent external review is not on the record for USAble Mutual Insurance Company in Arkansas, that is the absence stated at the top of this page and sourced at the foot of it.

##### How does USAble Mutual Insurance Company compare with other insurers in Arkansas?

Of the 4 insurers in Arkansas with a reported denial rate, USAble Mutual Insurance Company ranks 3 highest at 15%. The highest in Arkansas is HMO Partners, Inc. at 16.5%; the lowest is QCA Health Plan, Inc. at 8.8%.

##### What does USAble Mutual Insurance Company deny most often in Arkansas?

Benefit limit reached, 340,987 claims, 44.5% 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 Mutual Insurance Company 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 Mutual Insurance Company 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 Mutual Insurance Company denial in Arkansas cost anything?

The internal appeal to USAble Mutual Insurance Company 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 Mutual Insurance Company 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. The count is the one this page names as absent for USAble Mutual Insurance Company in Arkansas, so none is printed for it, an absent figure is not a count of none.

USAble Mutual Insurance Company sits at 15% in Arkansas 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.com

[Get my Appeal Kit, $29](/appeal-kit)
Everything you need for your USAble Mutual Insurance Company 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.

Where these numbers come from The USAble Mutual Insurance Company figures on this page, the 15% denial rate, the 570,178 denials, are this issuer’s own reported rows in that file. CMS did not report an external-review figure for USAble Mutual Insurance Company in Arkansas 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](https://data.healthcare.gov/) . Rights and timeframes: [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) (180 days, and your free right to the claim file) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) (4 months, and what qualifies), explained at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/external-review/) . 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)](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) and [govinfo.gov (45 CFR 147.136)](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) .

This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov.

Problem solved: You have both dates for your USAble Mutual Insurance Company notice, you know that Arkansas runs the external review itself, and you have the letter, free, on this screen, tonight.

## The pages that answer the next question

- [Every insurer reporting in Arkansas](/states/arkansas) , the state's own row, the 4 companies filing there, and the Arkansas insurance department's consumer number, read at source.

- [Wellmark Health Plan of Iowa, Inc. in Iowa](/insurers/wellmark-health-plan-of-iowa-inc--ia) , 18% of in-network claims denied, 745,842 of them, the neighboring record in this file.

- [Wellmark of South Dakota in South Dakota](/insurers/wellmark-of-south-dakota--sd) , 15.4% of in-network claims denied, 59,024 of them, the neighboring record in this file.

- [Wellpoint Insurance Company in Texas](/insurers/wellpoint-insurance-company--tx) , 11.9% of in-network claims denied, 113,708 of them, the neighboring record in this file.

- [If your employer pays the claims itself](/self-funded-denial) , then USAble Mutual Insurance Company is only administering the plan, your state's external review has no power over the denial, and the route is federal. It is the first question our own calculator asks. 4 insurers report in Arkansas; whether your plan is one of theirs at all is what that page settles.

- [If it was refused before the treatment](/prior-authorization-denied) , a prior-authorization refusal from USAble Mutual Insurance Company runs on the same two federal clocks as a denied claim, and it can be appealed while the treatment is still ahead of you. 1,437,735 in-network claims were denied in Arkansas in this release; a refusal before the treatment is not counted among them and is appealed the same way.

- [Before you pay a lawyer](/before-you-call-a-lawyer) , two free appeals run before anyone bills you by the hour, and USAble Mutual Insurance Company has to hand you the claim file for nothing under 29 CFR 2560.503-1. Free help in Arkansas starts with the state consumer line printed on that state's page.

- [All 152 insurer-state records](/insurers) , the whole table, ranked, with USAble Mutual Insurance Company in it and the 4 that file in Arkansas beside it.

Your dates are ready. [Write the letter, free](/appeal-letter)

## The two federal clocks

The clock your letter has to describe, in actual dates Whatever else is on the page, these two dates are the page. 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.

## How rare the second appeal is

You are not alone, measured rather than said: 83,907,852 in-network claims were denied in a single plan year, and only 4,918 of them, one in 17,061, ever reached the independent review stage. Of the ones that did, 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) were overturned.

## What is free here, and what the one paid thing costs

Denied a claim? Insurers upheld 165,863 of the 262,982 internal appeals counted in 2024, 63.1% ( KFF ). The win is at independent external review, and the only way to arrive there is to run the internal stage on time, in the right order, with the record intact. That sequence is what the Appeal Kit is. Get my Appeal Kit, $29 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. Get my Appeal Kit, $29 Everything you need for your appeal: 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.

## What we will not pretend

What we will not pretend. We cannot overturn your denial. Only your plan, or an independent reviewer, can do that. We cannot make your plan cover a service it genuinely excludes. We cannot guarantee external review applies to your denial. It covers medical judgment, experimental or investigational determinations, and rescission, a purely administrative denial may not qualify, and we say so on those pages rather than selling you past it. We have no customer testimonials and publish none. Our evidence is the federal dataset and the regulation cites, both of which you can check.

## Every page on this site

Home Start here Insurers By company States Denial reasons Use cases How to appeal Ranked by denial rate The external-review gap Write the letter, free Deadline calculator Self-funded plan? Prior authorization denied Medicare WISeR denial Denial code CO-50 Before you call a lawyer Attorney for a denied claim Your denial letter United Healthcare denying claims Time limits on a claim Appeal a Medicare denial About Editorial policy How we compare Privacy Terms For machines: llms.txt openapi.json changes.json the composed answer this page as markdown

## Which release these figures are

Which release these figures are Every number on this page is the plan-year 2027 Transparency in Coverage file, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. The dataset list is at data.healthcare.gov . A test in this site’s build fetches that list on every run and fails if CMS publishes a plan year we have not acknowledged here. Every earlier release, plan-year 2024, plan-year 2025, plan-year 2026, is kept alongside it so the record is visible rather than a single year’s snapshot; /about says what changed between them. From the plan-year 2024 release to the plan-year 2026 release, external reviews filed went from 2,336 to 5,881. Overturned reviews went from 32.8% in the plan-year 2026 release to 22.2% in plan-year 2027, or from 32.6% to 32.6% without SelectHealth. We do not compare filed or overturned counts across plan-years 2026 and 2027. Some issuers may have counted pre-service appeals in their 2026 cells.

## Where these numbers come from

Where these numbers come from 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) .

## Who publishes this

Denial Facts publishes federal data about health insurance claim denials. We are independent: not affiliated with, endorsed by, or acting for any insurer, government agency, or review organization. We are not a law firm, a medical provider, or an insurance producer, and nothing here is legal, medical, or insurance advice. Data: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Figures cover individual-market Qualified Health Plans on the federal Exchange and come from the plan-year 2027 release, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. See where the data comes from .

## Sources

- CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain: https://data.healthcare.gov/
- 29 CFR 2560.503-1 (180 days, and your free right to the claim file): https://www.ecfr.gov/current/title-29/section-2560.503-1
- 45 CFR 147.136 (4 months, and what qualifies): https://www.ecfr.gov/current/title-45/section-147.136
- HealthCare.gov on external review: https://www.healthcare.gov/appeal-insurance-company-decision/external-review/

Cite: Axion Labs — Denial Facts, "USAble AR appeal form and deadline", https://denialfacts.com/insurers/usable-mutual-insurance-company--ar (checked 2026-11-04). free to quote with the URL.