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Electrical, Thermal & Radiofrequency Therapy denials: what the review data shows
Independent reviewers have decided 1,115 published cases where an insurer denied electrical, thermal & radiofrequency therapy — and they overturned the insurer 43% of the time. If your denial is in this category, the odds say: appeal.
Published decisions
1,115
2001–2026
Overturned
43%
479 denials reversed
By denial reason
The excuse on the letter changes the odds — and the counter-strategy.
| Denial reason | Decisions | Overturned |
|---|---|---|
| experimental / investigational | 756 | 37.6% |
| medical necessity | 358 | 54.2% |
Within this category
Subcategories with at least 15 published decisions.
| Subcategory | Decisions | Overturned |
|---|---|---|
| Other | 385 | 40.3% |
| Radiofreq Ablat | 317 | 42.9% |
| TMS | 290 | 53.4% |
| Extracorp Shock Wave | 41 | 19.5% |
| Radiation Therapy | 31 | 48.4% |
| IDET | 30 | 6.7% |
How to use this in your appeal
These are outcomes from California’s external review program — an independent physician panel that binds the insurer. Every state has an equivalent process, and internal appeals succeed even more often. Cite the category outcome when you appeal: reviewers routinely find that denials like yours didn’t hold up.
SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY
Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.