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Overturned Health Insurance Claim Denials | Synapse

April 15, 2026

Overturned Health Insurance Claim Denials

Key Points

This research aims to explore the clinical and administrative aspects of overturned health insurance claim denials.
Conducted a case series from 2019 to 2025
Analyzed insurance claim appeals and decision reversals in New York State
Evaluated clinical and administrative characteristics of claims
Identified common reasons for claim denials
Reversal rates of denied claims varied by type of service
Clinical characteristics influenced appeal success rates

Abstract

This case series examines the clinical and administrative characteristics of insurance claim appeals, denials, and decision reversals in New York State from 2019 to 2025.

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Authors

A

Ayesha Rahim

K

Kirsten Eom

J

Joseph Dov Bruch

Journals

JAMA Internal Medicine

Actions

Institutions

University of Chicago

Brown University

The University of Texas Health Science Center at San Antonio

References and Citations

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Cite this study

Rahim et al. (Mon,) studied this question.

www.synapsesocial.com/papers/69df2b04e4eeef8a2a6b0075 — DOI: https://doi.org/10.1001/jamainternmed.2026.0358