Guide · After a decision
Got a letter? Here's what it's really saying.
Decision letters can be hard to read. Let's read yours together, one line at a time.
Reading your letter
Find the decision
Approved, partly paid or denied. It is near the top.
Find the code
A short code like CO-50 explains why.
Look it up
We show what the code means and the page it comes from.
Check the date
The letter says how long you have to ask for another look.
Codes people ask about
Example codes
CO-50
Usually means the plan decided the service was "not medically necessary".
CO-45
The charge is above the amount the plan agreed to pay for it.
PR-1
The amount went toward your deductible.
CO-97
The payment was already included in another service.
The appeal window, as an example
Yours is on your letter. We show how to read it.
Example
Date on the letter.
Many plans use a window of 60–180 days to ask again. Check your policy page.
The date on your letter is the one that counts.
You decide what comes next.
We show what the document says. You decide whether to ask for another look.
We don't write to your insurer or call for you.