the-lesser-known-trick-you-can-use-to-dispute-high-medical-bills

Uncover a Little-Known Tip to Dispute High Medical Costs

   February 27, 2026  Posted in Money, News

26, 2026 6:30 am EST

A man with his arm in a sling signing a billMediaphotos/Getty Images

Medical services are one of the biggest expenses for many Americans, with the average family spending over $5,000 on healthcare in 2023. When insurance is involved, things get even more complicated as patients worry about unapproved procedures or uncovered medications leading to more financial troubles. While fighting an insurance company’s decision may seem scary, consumers do have the legal right to appeal. But less than 1% of people actually do this, according to experts.

Through an external appeal, consumers can challenge an insurer’s decision to deny coverage for treatment. To use this, a patient and their doctor submit a request to a state-approved Independent Review Organization (IRO) to start the external appeal process. The IRO assigns independent medical experts not affiliated with the insurance company to review the claim and medical records to see if the denied treatment is necessary. Based on their decision, the insurer could be forced to cover the cost.

Essential info about the external review process

Group of docotors in a meeting.Skynesher/Getty Images

Before requesting an external review, you have to go through your insurer’s internal appeal process first. During this, the insurance provider will evaluate if their initial decision was right. Whether you’re a senior trying to avoid high costs or a younger patient looking to save money, this first step can be an effective way to cut down healthcare expenses on its own.

If the internal appeal gets denied, that’s when you can consider the external review. But there are strict requirements – you must submit a request in writing to your state’s IRO within 4 months of the insurer’s final decision. In states without external appeal options, you can contact the Department of Health and Human Services instead. The IRO has 45 days to make a binding decision. The Affordable Care Act also allows for expedited external reviews in emergencies. While results may vary, if you’re facing a big medical bill you believe should be covered, it’s worth trying to appeal. Some people have had great success with the external review process.

Author: John Meyer