Health Agent · Denial-substance recognizer
A denial's words are the form. Find the structure underneath.
Insurers write denials in language that sounds final — "not medically necessary," "experimental," "try the other drug first." Underneath the wording is a structure, and some structures are recognizable: a procedural denial dressed as a clinical one, a fail-first the record already satisfies, a request for a document only the blocked visit could produce, a decision that landed after the plan's own deadline. Answer a few yes/no questions about your own record and this page names the pattern — and the exact mismatch to raise. It runs entirely in your browser.
Recognizer
Answer about your own record. See the pattern.
Result
In one line
The whole check runs in the page you already loaded — no upload, no account, no server call. Health Agent never sees the medication, the diagnosis, or the patient. See the proof →
How it works
It recognizes a structure — it does not rule the case
Each known pattern is a small set of structural facts that have to all be true at once. "Procedural denial dressed as medical necessity," for example, is recognized only when the denial points to a criterion, your record already meets that criterion, and there is no documented contraindication. If any one of those is missing, the pattern does not match — the tool says so rather than reaching.
It never tells you the denial is wrong, illegal, or that you will win. That is adjudication, and only the plan and the appeal process decide it. What the tool gives you is the name of the mismatch — the specific structural point to put in front of the appeal, the prior-auth readiness checker, or the local appeal desk.
After you name it
Turn the pattern into the appeal
Once you have the structural mismatch, the next move is the appeal itself. The local appeal desk drafts the letter on your own computer so records never leave your hardware; the deadline checker tells you how long you have to file; and the prior-auth readiness checker lists the evidence a given denial reason needs. A recognized pattern doesn't replace any of those — it tells you which point to lead with.
Questions
Common questions
Does anything I answer get sent anywhere?
No. The recognition is computed by code already running in your browser. There is no server endpoint behind this page; your answers never travel over the network and are not stored. Close the tab and nothing is kept.
Does "pattern recognized" mean my denial is wrong?
No. It means the situation you described has the shape of a known pattern — a structural mismatch worth raising. It is not a ruling that the denial is wrong, illegal, or invalid; only the plan and the appeal process decide that. Use the recognized mismatch as the point you lead with in your appeal.
What if no pattern matches?
That does not mean the denial is correct. It means this tool's known patterns didn't fit the facts you gave — there are many valid reasons to appeal that aren't one of these shapes. The fight-a-denial guide and the appeal desk work regardless.
Is this medical or legal advice?
No. It names a structural pattern and a drafting point. It does not diagnose, adjudicate coverage, file appeals, or guarantee any outcome. Clinical decisions are the treating physician's. Confirm criteria and deadlines with the plan and at medicare.gov.