Work through an insurance external appeal for a child's surgery with ChatGPT

Posted

Oct 28, 2025 by chrisgeleven (Hacker News)

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Last checked

Oct 16, 2026

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Method:

How we verify

Evidence: Described by posterThe person describes what happened in words, without screenshots or video.

Outcome

A Hacker News commenter says that after insurance declined a life-saving surgery for their 6-year-old at the last minute, ChatGPT guided them through the external appeal process, suggested who to contact to apply pressure, researched questions and helped with wording. They didn't follow every suggestion and checked steps with friends and family; the procedure was approved 10 days after the denial.

Agent

ChatGPT

The source didn't share its exact prompt, so we wrote this from what it describes.

Let's work this out together. I'll tell you what I know, you suggest options and ask what you need, and we'll narrow it down step by step. Nothing gets booked, bought or sent until I say so.

Goal: Map out and work through the appeal for a denied insurance claim, step by step, as fast as the process allows.

What I'll share as we go:
- The denial letter (remove names, member ID and birth dates)
- Plan type (employer, marketplace, Medicaid) and state
- How urgent it is, and what the doctor's office says
- Dates so far, and any deadlines in the letter

This is admin help, not medical advice. Don't diagnose or suggest treatments. If anything I mention sounds urgent, tell me to contact a doctor or emergency services first.

Rules:
- Start with the exact appeal steps and deadlines for my plan type, including expedited or urgent review if it applies.
- List who to contact and in what order (insurer, doctor's office, employer benefits, state insurance department), with what to ask each.
- Draft appeal wording from facts in my documents only; mark anything I need the doctor to supply.
- This is admin help: decisions about the treatment stay with the doctors.
- Check facts that can change (prices, opening hours, dates, availability, rules) against the official source, and tell me anything you couldn't verify.

Output: A step list with deadlines, a contact plan, and a draft appeal letter with blanks for the doctor's input.

You'll know it worked when: every deadline is on my calendar, the right people have been contacted, and the appeal is filed with the doctor's support.

Let's work this out together. I'll tell you what I know, you suggest options and ask what you need, and we'll narrow it down step by step. Nothing gets booked, bought or sent until I say so.

Goal: Map out and work through the appeal for a denied insurance claim, step by step, as fast as the process allows.

What I'll share as we go:
- The denial letter (remove names, member ID and birth dates)
- Plan type (employer, marketplace, Medicaid) and state
- How urgent it is, and what the doctor's office says
- Dates so far, and any deadlines in the letter

This is admin help, not medical advice. Don't diagnose or suggest treatments. If anything I mention sounds urgent, tell me to contact a doctor or emergency services first.

Rules:
- Start with the exact appeal steps and deadlines for my plan type, including expedited or urgent review if it applies.
- List who to contact and in what order (insurer, doctor's office, employer benefits, state insurance department), with what to ask each.
- Draft appeal wording from facts in my documents only; mark anything I need the doctor to supply.
- This is admin help: decisions about the treatment stay with the doctors.
- Check facts that can change (prices, opening hours, dates, availability, rules) against the official source, and tell me anything you couldn't verify.
- Keep a dated log of every call and letter so I can show it in an external review.

Output: A step list with deadlines, a contact plan, and a draft appeal letter with blanks for the doctor's input.

You'll know it worked when: every deadline is on my calendar, the right people have been contacted, and the appeal is filed with the doctor's support.

Before you finish: re-read my goal and constraints, check your answer against each one, and list anything you assumed or couldn't confirm.

Source

https://news.ycombinator.com/item?id=45736945