How does Counterclaim generate an insurance appeal letter?

Counterclaim uses a 5-agent AI pipeline. The Reader extracts claim data from your document. The Researcher identifies applicable state insurance law. The Writer drafts a formal appeal letter. The Adversary identifies weaknesses. The Editor rewrites the letter to eliminate all weaknesses. The final letter is ready to print and mail in minutes.

Is Counterclaim free to use?

Yes - Counterclaim is free during the launch period. Upload your denial letter and receive a complete adversary-tested appeal letter at no cost. No account required.

What types of insurance denials can Counterclaim handle?

Counterclaim handles all major denial types: medical necessity (CO-50), prior authorization (CO-11), experimental treatment (PR-1), fee schedule (CO-45), timely filing (PR-27), not covered (CO-4), step therapy (PR-50), and missing information (CO-16).

What file formats does Counterclaim accept?

Counterclaim accepts PDF files, JPG and PNG photos, and scanned documents of your denial letter or Explanation of Benefits (EOB).

Does Counterclaim provide legal advice?

No. Counterclaim generates appeal letters based on publicly available legal and clinical information but does not constitute legal advice. For complex cases, consult a licensed healthcare attorney or certified patient advocate.

How do I file an Ohio external review?

Within 180 days of the insurer's final adverse determination, file with ODI under ORC chapter 3922. ODI assigns an IRO randomly from its certified roster. The decision is binding on the insurer.

Where do I file an Ohio insurance complaint?

ODI Consumer Services at 1-800-686-1526 or online at insurance.ohio.gov/consumers/file-a-complaint. The complaint process is separate from external review and can run in parallel.

How long does Ohio external review take?

Standard external review is decided within 30 days of IRO assignment. Expedited external review within 72 hours when delay would seriously jeopardize health.

Can I file expedited review in Ohio?

Yes - within 72 hours under ORC section 3922.10 when delay would jeopardize health. Provide a written physician statement confirming clinical urgency.

What is the deadline to file the internal appeal in Ohio?

ACA-regulated plans give at least 180 days from the date on the denial notice. The exact deadline is on your denial notice and EOB.

Are Ohio external review decisions binding on my insurer?

Yes. Under ORC chapter 3922, the IRO determination is binding on the insurer. There is no further administrative appeal. Failure to comply is grounds for ODI enforcement action.

Does Ohio have surprise billing protections?

Yes. House Bill 388 of 2022, codified at ORC chapter 3902, limits patient liability for emergency services and certain non-emergency services at in-network facilities to in-network cost-sharing amounts. The state law complements the federal No Surprises Act for services not federally covered.

Does Ohio cover ABA therapy for autism?

Yes. ORC section 3923.84 requires Ohio-regulated commercial plans to cover medically necessary treatment for autism spectrum disorder including applied behavioral analysis, subject to specified clinical criteria. Denials based on age caps or non-medical criteria inconsistent with statute are appealable.

Ohio Insurance Appeal Letter Generator - Cite Ohio Revised Code 3922

The Ohio Department of Insurance administers external review under Ohio Revised Code chapter 3922. Decisions are binding and IRO assignment is randomized through the ODI. Upload your OH denial and our 5-agent AI pipeline drafts an appeal under the Ohio Revised Code.

Ohio insurance regulator

ODI regulates fully insured commercial plans and Health Insuring Corporations (HMOs) in Ohio. The state operates an external review program under Ohio Revised Code chapter 3922.

Ohio Department of Insurance (ODI)File a OH insurance complaint

External review in Ohio

External Review under Ohio Revised Code chapter 3922. Decided by an IRO randomly assigned by ODI from its certified roster. Free, binding. Standard reviews are decided within 30 days; expedited within 72 hours.

Internal appeal timing in Ohio

Ohio insurers follow ACA-floor timelines: 30 days pre-service, 60 days post-service, 72 hours expedited. Patients have 180 days to request external review after the final adverse determination under ORC chapter 3922 - among the longer state filing windows.

Statutes Counterclaim cites for Ohio appeals

Ohio Revised Code chapter 3922 (External Review)
Ohio Revised Code chapter 3923 (Sickness and Accident Insurance)
Ohio Revised Code chapter 1751 (Health Insuring Corporations)
Ohio Revised Code section 3923.04 (mental health parity)
Ohio Revised Code section 1751.84 (continuity of care)
Ohio Revised Code section 3923.65 (utilization review)

Generate your Ohio appeal letter

Upload your denial. Our 5-agent AI pipeline drafts a professional appeal citing the right Ohio statute in about 2 minutes, free.

Upload my denial · Free

Frequently asked questions: Ohio appeals

California appeal letter

Texas appeal letter

Florida appeal letter

New York appeal letter

Pennsylvania appeal letter

Illinois appeal letter