Some patients are bringing insurance coverage disputes directly to health insurer CEOs, seeking another avenue for review when recommended care is denied, MedPage Today reported Oct. 8.
Two patients recently obtained coverage approvals after contacting insurance company executives, according to the report. In one case, an insurer approved a chemotherapy treatment after the patient, a writer for Vanity Fair, emailed the CEO. In another, the insurer agreed to cover surgery with an out-of-network specialist at the in-network rate after a patient sent an 11-page appeal written with the help of AI to the insurer’s CEO and copied other executives, lawmakers and journalists.
Wendell Potter, a former Cigna executive, told MedPage Today that large insurers have teams that handle high-profile cases and concerns elevated to executive leadership or public relations departments. He encouraged patients and clinicians to consider additional avenues for challenging denials, though he cautioned that physicians who repeatedly escalate disputes could risk straining relationships with insurers.
Stephen Parente, PhD, chair of health finance at the University of Minnesota in Minneapolis, suggested physicians could also contact an insurer’s medical director to explain the clinical need for treatment and discuss concerns behind a coverage decision, MedPage Today reported.
The cases come amid broader concerns about coverage denials and appeals. A June Commonwealth Fund survey found that 21% of privately insured U.S. working-age adults reported a coverage denial affecting themselves or a family member in the previous year. Only about half of those who experienced a denial appealed the decision, according to the survey.
The issue also carries operational implications for hospitals. Cleveland Clinic reported a 15% incoming denial rate, including initial and subsequent denials, in 2025 and said its revenue cycle team ultimately overturned 92% of those denials. The health system has embedded medical directors in revenue cycle operations and developed a physician advisory program to help address potential denials before claims are submitted.
Technology is also entering the appeals process. One of the patients featured by MedPage used Claimable, an AI-assisted appeals platform, to prepare his request. The company uses AI to generate appeals based on insurance law, medical research and other information, and has explored partnerships with health systems to manage appeals on patients’ behalf.
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