HOW IT WORKS

Three steps. One appeal letter.

From ERA file to complete MHPAEA-compliant appeal letter in under four minutes.

Drop your 835 ERA file
STEP 01
Upload your ERA file.
Drag and drop your 835 EDI file. Every claim, every CARC code, every payer adjustment — read and parsed instantly.
#84921 · $240
CO-96MHPAEA
#84887 · $180
CO-197
STEP 02
Every denial decoded.
CARC codes translated into plain language. MHPAEA parity violations flagged automatically. You see exactly what is worth contesting.
RE: Appeal — Claim #84921
45 C.F.R. § 2590.712
...limitations applied to mental health benefits shall be no more restrictive...
STEP 03
A complete letter, ready.
Cites the specific federal regulation. Tied to the exact denial. Review, sign, submit. Minutes, not hours.

DENIAL CODE ANALYSIS

Every code decoded. Every violation flagged.

DenialIQ translates every CARC and RARC code into plain language and identifies potential MHPAEA violations automatically.

835-ERA-analysis · 3 denial codes detected
2 MHPAEA FLAGS
CO-96
Non-covered charge
Applied to a mental health service with a medical/surgical comparator — potential impermissible benefit exclusion under MHPAEA.
MHPAEA appeal → 45 C.F.R. § 2590.712
CO-197
Prior authorization required
If prior auth is required for mental health visits but not equivalent specialist visits, this administrative disparity is a NQTL violation.
NQTL disparity → comparative analysis required
CO-4
Service not covered
Coverage gaps for behavioral health may indicate parity violations if comparable physical health services are covered under the same plan.
Coverage comparison → appeal with benefit evidence

THE LETTER

What a DenialIQ appeal letter actually looks like.

Generated in four minutes. Formatted for formal submission. Citing the exact federal regulation tied to your specific denial.

Pacific Mental Health Group
123 Therapy Lane, Suite 200
Portland, OR 97201

May 10, 2026

Aetna Health Plans
Appeals Department
P.O. Box 14079
Lexington, KY 40512
RE: Appeal of Claim #84921
Aetna Health Plans · Denial Code: CO-96
Date of Service: May 2, 2026

Dear Appeals Review Board,

We write to formally appeal the denial of the above-referenced claim, submitted for outpatient mental health services provided on May 2, 2026. The claim was denied under adjustment reason code CO-96 (Non-Covered Charge).

Pursuant to 45 C.F.R. § 2590.712, the Mental Health Parity and Addiction Equity Act (MHPAEA) prohibits group health plans from applying financial requirements or treatment limitations to mental health benefits that are more restrictive than those applied to substantially all medical and surgical benefits.

The denial of this claim appears inconsistent with the plan's obligations under MHPAEA. Specifically, the plan appears to apply coverage restrictions to outpatient mental health services that are not applied to comparable medical or surgical services under the same plan...

Generated excerpt. Full letters include clinical documentation, comparative plan analysis, and formal requests under the Consolidated Appropriations Act, 2021.

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