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Press & research — CaseWhy Appeals
The story in three sentences
Peter, CaseWhy's founder, spent fifteen years as a solution architect. His own family's Medicare letters kept arriving without an explanation anyone could understand — what was denied, why, and by when it had to be appealed. CaseWhy Appeals is the tool he wished had existed: it explains the notice, writes the appeal, and tracks both deadlines.
The appeal paradox
Only about 1 in 9 Medicare Advantage prior-authorization denials gets appealed (11.5%) — but more than 8 in 10 of the appeals that are filed win (80.7%). Source: KFF, Jan. 28, 2026, analyzing 2024 CMS Medicare Advantage prior-authorization data.
Facts
- What it is: a web app at appeals.casewhy.com that explains a Medicare denial notice in plain language with the rule cited, computes both appeal deadlines, writes the appeal letter, fills the CMS forms for that level, and tracks the case through every level up to the Medicare Appeals Council.
- Coverage: every Medicare appeal type — Medicare Advantage, Part D, Original Medicare, premiums (IRMAA and late-enrollment penalties), enrollment, and PACE. See the full coverage map.
- Professional seats: free, permanently, for SHIP/SHINE counselors, long-term care ombudsman programs, legal aid, and nonprofit staff; $99/month per seat for independent advocates, care managers, and attorneys (free through the founding pilot, to Feb. 28, 2027); a per-site license for facilities.
- Data: no client identity is ever stored — a client is a label and a reference number the professional chooses.
- Company: CaseWhy LLC, St. Petersburg, Florida, founded 2026. No outside funding.
Founder
Peter, founder, Florida. Fifteen years as a solution architect in enterprise IT; built CaseWhy Appeals after his own family's Medicare denial letters were impossible to make sense of on a deadline.
Contact
appeals-help@casewhy.com · Logo pack & boilerplate: see Resources