Dearbh — Appeal a denied claim with proof

What one appeal line looks like

Physical & speech therapy Illustration

Insurer says

Denied

“The records you sent do not support the therapy you asked for.”

Dearbh finds

Your plan has to tell you exactly what was missing, not just that something was.

“The notification shall set forth, in a manner calculated to be understood by the claimant— (i) The specific reason or reasons for the adverse determination; (ii) Reference to the specific plan provisions on which the determination is based; (iii) A description of any additional material or information necessary…”

Quoted word for word · 29 C.F.R. §2560.503-1

You get

Documents received

Your therapist’s progress notes
Your doctor’s order for therapy

Documents outstanding

The plan’s written list of exactly what it says is missing Dearbh drafts the requestUntil the plan names it, there is nothing to answer. This turns a vague no into a specific one.
The visit notes for the sessions already refused Dearbh drafts the requestThese show the therapy was given and what it achieved, which is what the plan says it cannot see.

You can file now.

The plan has to say exactly what was missing, and it did not. Dearbh drafts that letter and the record request together, so the clock keeps running while the notes arrive.

Prescription drugs Illustration

Insurer says

Denied

“This drug is not on your plan’s list of covered drugs.”

Dearbh finds

Your plan has to give you and your doctor a way to ask for a drug it does not cover.

“A health plan providing essential health benefits must have the following processes in place that allow an enrollee, the enrollee’s designee, or the enrollee’s prescribing physician … to request and gain access to clinically appropriate drugs not otherwise covered by the health plan (a request for exception).”

Quoted word for word · 45 C.F.R. §156.122

You get

Documents received

Your prescription
The drugs you have already tried

Documents outstanding

Your doctor’s written justification for this drug Dearbh drafts the requestThis is the centre of the appeal. It is what says this drug, for this patient, for this reason.
Notes on how the covered alternatives worked, or why they cannot be used Dearbh drafts the requestA formulary denial assumes something else will do. This is what answers that.
The plan’s formulary showing what it covers in this class Dearbh drafts the requestIt shows whether the plan covers anything at all here, which is the point the rule turns on.
The plan’s written decision on your exception request Dearbh drafts the requestWithout it there is no decision to appeal, and the clock may not have started.

Get one thing first.

Your doctor’s written justification is the strongest thing missing. Dearbh drafts the request for it. If your deadline is close, it files to protect the date and adds the justification to the file after.

Home health hours Illustration

Insurer says

Denied

“Your home health hours are being cut.”

Dearbh finds

You have a right to a fair hearing when a claim is denied or is not acted on.

“Section 1902(a)(3) of the Act requires that a State plan provide an opportunity for a fair hearing to any person whose claim for assistance is denied or not acted upon promptly.”

Quoted word for word · 42 C.F.R. §438.400

You get

Documents received

Nothing in your file supports this yet. Dearbh will not write a line it cannot back, so it asks for these first.

Documents outstanding

The notice stating the reason and the date the cut starts Dearbh drafts the requestEverything runs from this. It carries the reason, the rule, and the date your deadline counts from.
Your plan of care Dearbh drafts the requestIt is what set the hours in the first place. Without it there is nothing to measure the cut against.
Your nurse’s assessment of the hours you need Dearbh drafts the requestThis is the clinical answer to why the hours are needed, which is what the cut disputes.
The state rule the plan says it is applying Dearbh drafts the requestThe plan has to name the rule. Until it does, no one can show it was applied wrongly.
The plan’s own decision on your appeal to it Dearbh drafts the requestWith a managed-care plan the plan’s appeal usually comes first, and its decision is what opens the state hearing. Filing in the wrong place can cost you the deadline.

Not ready to file.

Dearbh will not tell you this appeal is backed when nothing in your file supports it. Get the notice and your plan of care first. If the deadline is close, Dearbh files to protect the date and says plainly, in the letter, which records are still coming.

Each tab shows one line of an appeal. A real denial letter usually gives several reasons at once. Dearbh answers every one of them separately. Each line gets its own rule, its own records, and its own entry in the file, so you can see what backs it and nothing in the letter goes unanswered.

Which rule governs depends on the kind of plan you have. These four run on different law: an employer plan, a marketplace plan and Medicaid each answer to a different rulebook. Dearbh works out which one applies to you before it writes a word.

How it works

You see what is missing before the insurer does.

1

Add your denial and records

Drop in the denial letter and everything you have — records, notes, and your plan documents. Your case is handled under a signed agreement that covers health information.

2

Dearbh reads it and finds the gaps

It checks your records against what your appeal needs to prove, and shows you what already has support and what is still missing.

3

Get what is missing

Dearbh helps write the letters that reply to the insurer and request the outstanding records, so your file is complete before you appeal.

4

Check the proof, then file

The appeal quotes every source word for word. You see the real text behind every line, and nothing goes in that you can’t verify.

What we offer that others don’t

Proof you can check, not a black box.

Most tools draft a letter and hope. Dearbh proves every line against its real source and keeps a person on the calls that matter — so what you file can stand up.

Every citation is real

Each source is the exact text from the actual law, policy, or label. No invented studies, no “trust us” database you can’t see. One made-up citation can sink an appeal. Dearbh proves every one against its source.

A person is in the loop

AI does the heavy lifting, but a human reviews the calls that matter. Nothing files itself. You stay in control of every line before it goes out.

Made to be used by everyone

Built to work with eye-tracking, switch access, and speech recognition, because it was built by someone who uses them every day.

You choose where your case is kept. Keep it on your own system and we hold nothing.

The denial that never stops

When you rely on ongoing care, the denials come every month, not once.

It is the refill, the wheelchair, the CPAP, the therapy hours, and the home-health visits — the everyday equipment and care that people with disabilities, chronic illness, injury, and rare diseases depend on, coming back denied. A denial is not the end of the process. It is the start of one.

Wheelchairs & mobility

Speech devices

CPAP / BiPAP

Physical & speech therapy

Home health hours

Medical foods

Genetic testing

Prescription drugs

Mental & behavioral health

Diabetes supplies & CGM

Skilled nursing & rehab

Prior-auth renewals

It’s not only private insurance, and it’s not only rare disease. Dearbh appeals denials across the programs people rely on for ongoing care — at first application, at renewal, or after years of coverage.

Private & ACA health plans Medicare Medicaid SSDI — Social Security Disability Insurance SSI — Supplemental Security Income

SSI appeals include federally-administered state supplement (SSP / optional state supplement) determinations. If you can be denied, you can appeal — and Dearbh proves every point against the rule that governs it.

The story behind it

A thousand denials. One tool built to answer them.

Dearbh’s founder at his desk in a wheelchair, wearing a head-mounted eye-tracking device, working at a computer.

Dearbh was built by someone who has been denied by insurers a thousand times — and who got tired of losing appeals he should have won.

Its founder lives with spinal muscular atrophy type 2, and navigates computing, development, and communication through eye-tracking and speech recognition. Like everyone with a rare disease, he has faced the denials that never stop.

It is rarely the one big drug. It is the wheelchair, the standing frame, the speech device, the therapy hours, and the renewal that comes back denied after years of being stable. Each one costs time, money, and energy that a person managing a rare disease cannot spare. Most people give up. Nothing on the market was built for that reality, or by someone who lives it.

So he built the appeal engine he needed, and made it one everyone can use.

Built with AI as the force multiplier that made it possible.

Built and used every day with Tobii Dynavox for eye-tracking and Cephable for speech recognition. Its founder is a proud Permobil M3 power wheelchair user, with durable medical equipment provided by Numotion.

Who it’s for

Whether you’re fighting one denial or a thousand.

Dearbh is built for everyone who meets the same wall — individuals, advocates, clinics, and law firms — and gives each of them proof an insurer or agency can’t wave away.

Individuals & families

Fight your own denial with an appeal built on the real rules and your own records, with a source behind every line.

Advocates

Handle far more families with the same hours. Every letter is cited, checkable, and ready — so nothing goes out you can’t stand behind.

Clinics & foundations

Give your specialists a tool that carries your name, learns your community’s denials, and reports your impact — running inside your own network.

Law firms

Build appeals and demand letters on citations that hold up. Every source is quoted word for word and traces to the rule that governs it — ready for the record.

Pricing

Straightforward pricing. Fair when you scale.

For one person

Free

Free for one person. The full engine, for your own appeal.

Nothing to install
Keep your case on your own system
Every citation checkable

Multiple appeals

Contact us

For anyone running more than one appeal. Tell us what you need.

No install, works in your browser
Pay only when you file
Cited, ready-to-send letter

Institutions

Contact us

Foundations, clinics, and advocacy teams.

Your name on it (white-label)
Runs inside your network
Shared knowledge base & impact reports

Join the waiting list

Dearbh is in live testing and verification review now. Tell us who you are and we will let you know the moment it opens. If you want to help shape it, you can ask to join the group that tries it first.

Your name

Email address

Which one describes you?

Type of denial — optional

I would like to help test it first. We will ask a small group to try Dearbh early and tell us what does not work. Testing has its own separate agreement, and you can say no when we ask.

I agree that Dearbh can keep my name, my email, and the answers I picked above. Dearbh may use them to email me when it opens and to plan what to build first. I can ask to be deleted at any time. Read the privacy notice.

We ask for the type of denial only as a category, so we know which problems to build for first. Please do not send us medical records or case details here — this page is not where a case lives.

Your denial isn’t the last word.

Build an appeal on proof they can’t wave away.

Get early access

Denied by insurance? Build an appeal backed by the insurer’s own rules.

You see what is missing before the insurer does.

Add your denial and records

Dearbh reads it and finds the gaps

Get what is missing

Check the proof, then file

Proof you can check, not a black box.

Every citation is real

A person is in the loop

Made to be used by everyone

When you rely on ongoing care, the denials come every month, not once.

A thousand denials. One tool built to answer them.

Whether you’re fighting one denial or a thousand.

Individuals & families

Advocates

Clinics & foundations

Law firms

Straightforward pricing. Fair when you scale.

Join the waiting list

Your denial isn’t the last word.