Denied Ozempic, Wegovy or Zepbound? A surgery, MRI, or therapy claim rejected? Fewer than 1% of patients appeal — yet appeals win up to 80% of the time. Ovryt reads your denial letter, tells you your odds, writes the appeal, and tracks it until you get an answer. It audits hospital bills for errors, too — and providers can use it to clear their denial backlog.
Figures from KFF analyses of 2024 ACA-marketplace and Medicare Advantage claims data (published 2026). Ovryt helps with paperwork and advocacy — it is not medical or legal advice.
Photo of the letter, a PDF, or pasted text. We extract the claim details, the CARC reason code, and your deadlines automatically.
Every denial reason has a track record. We tell you honestly whether your denial is worth fighting — most are — and which argument wins for it.
A complete appeal letter ready to sign and send — then a deadline countdown on every saved case, and a one-click external-review escalation if the insurer says no again.
Insurers overturn their own denials at astonishing rates the moment someone pushes back — proof that many denials were never solid to begin with. The catch: almost nobody pushes back.
Sources: KFF analyses of CMS Medicare Advantage data (Jan 2026) and 2025 payer transparency reporting (Aug 2026); JAMA-published New York external-review study; Pennsylvania Insurance Department. Denial rates also vary wildly by insurer — from 8% (Elevance) to 25% (Oscar) of in-network ACA claims in 2024 (KFF, Mar 2026).
| Reason code | What the insurer says | What it usually means | Appeal win rate* |
|---|---|---|---|
| PA / formulary | "Weight-loss drugs excluded" / "step therapy not met" | GLP-1 denials (Ozempic, Wegovy, Zepbound) often ignore your diabetes, cardiovascular, or comorbidity indications — the insurer's own formulary criteria frequently support coverage. | ~60% |
| CO-50 | "Not medically necessary" | A reviewer who never met you disagreed with your doctor. A peer-reviewed letter from your physician overturns many of these. | ~52% |
| CO-197 | "Prior authorization missing" | Often a paperwork failure by the provider, not you — and retroactive authorization is frequently granted on appeal. | ~60% |
| PR-204 | "Not covered by your plan" | Plans misclassify services constantly. Your Summary Plan Description is the contract — and it often says otherwise. | ~45% |
| CO-16 | "Claim lacks information" | A coding or data-entry error. The easiest category to fix — resubmission with corrected codes usually resolves it. | ~70% |
| CO-29 | "Filed too late" | Timely-filing denials are the provider's responsibility in most contracts — you may owe nothing at all. | ~55% |
*Illustrative rates drawn from published appeal-outcome studies; your odds depend on your plan and documentation.
Nothing tracked yet. Analyze a denial above and press Save & track — your case, its deadline countdown, and your appeal letter will live here. If the insurer says no again, we generate the external-review escalation. Cases are saved privately on this device.
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