How Inciteful Med Helped Me Win an Appeal

Professional health advocates are resourceful and always on the hunt for new tips and tricks to assist patients. Each patient is different. Red tape is common. Sometimes healthcare organizations execute flawlessly; sometimes they make mistakes. So we fill our quivers with all the arrows we can find.

One such arrow is Inciteful Med, which I have found invaluable in my advocacy practice. While my own particular expertise includes insurance policies, medical bills, and how the overall system operates, I am not a doctor, nurse, or any other type of clinically trained expert. So I am especially appreciative that Inciteful Med puts "Expert medical knowledge at your fingertips" as their website accurately describes.

I first learned about Inciteful Med in the fall of 2025 at the New England Patient Advocacy Conference, where co-founder Erika Warren presented their mission, demonstrated the application, and discussed artificial intelligence in healthcare more broadly. Needless to say, the presentation was well-received by the audience! I started using Inciteful Med immediately after. Below, I'll illustrate how it helped me win an appeal for one of my clients.

This isn't a sponsored post; I have no financial relationship with IncitefulMed. I'm writing this post to illustrate one way I've used the application and how you can too.

Patient story

One of my clients had suffered a stroke. After being transported to the hospital, the care team performed a procedure to address the stroke, stabilized the patient, and diagnosed why it occurred. They then performed a mainstream surgery that directly addressed the underlying condition and averted a second stroke.

The patient was back home in three days. That’s a good outcome, right?

Soon after this episode, the patient's insurance started paying its share of the bills. Ambulance, tests, check check …. except they didn’t pay for everything. Remember that mainstream surgery that directly addressed the underlying condition and averted a second stroke? Yeah, the insurer considered that not “medically necessary”.

Wait, what?

Though our healthcare system frequently produces wonderful medical outcomes like this patient's recovery, it is also confusing and expensive when it doesn’t function well. Nearly one in five claims is denied by a health insurer. Four in ten Americans carry medical debt.

I helped this patient successfully use the appeals process to overturn their health plan’s denial. Turns out that the health plan favored a different procedure unless certain conditions are met. Since an appeal is a contractual argument that an insurer should pay for services per the language in their own policy, you need to interpret medical information and policy language to prove your argument; in this case, that the surgery met the policy criteria.

This is a huge barrier for most people, even when the appeal is winnable. But help is available. Here’s how I used Inciteful Med to win this case.

Appealing the Denial

Education

My first task was to get up to speed on the patient’s condition and the procedures in question. After speaking with the patient, I started asking Inciteful Med broad questions, then got more specific.

Asking Inciteful Med a broad question

Getting more specific with my questions in Inciteful Med

Can I get the same information from other popular AI applications? Sure some of it, but it’s not ideal. One, Inciteful Med draws upon published medical literature to answer your questions. You can easily access the article abstracts to verify. In addition, applications like ChatGPT employ fundamentally different engagement models; their incentive is to keep you chatting, not to efficiently address the information asymmetry at work in the healthcare system.

Having said that, I do use AI applications such as ChatGPT, Claude, and NotebookLM for fact-finding, confirming information, and drafting content. Other sources of trusted medical information that I use include the Mayo Clinic and the Cleveland Clinic.

Analysis

Once I gained familiarity with the patient's conditions and procedures, I then had to find the evidence within the patient’s medical records and from medical literature that we needed to win.

I want to emphasize how important collaborating with your care team is, because they’ll help point the way. (Note that sometimes doing so is its own challenge; they are time-crunched and have competing priorities.) Ideally you want to hear a version of “here’s why we performed x and not y and here’s what to look for”. Continue to use Inciteful Med as a knowledge source, so your conversations are as productive as possible.

Once you know what to look for, extract the evidence from your sources to support your case. (And no matter how knowledgable you become, a “Letter of Medical Necessity” from your provider is important for appeals.)

You can also use Inciteful Med to sharpen your arguments once the strategy and framework are in place. I love its nuanced answers that push my thinking. Here’s an example of me exploring arguments that the insurer's favored treatment would have been inappropriate:

Inciteful Med answering with nuance

The answer in turn led me to ask further probing questions. IncitefulMed also suggests follow-up questions.

Sources

Medical literature is the heart of Inciteful Med’s data. That’s a powerful backing for your own education and analysis. I always click into View Sources and keep track of which article support my arguments and facts so I can cite those sources. (I ultimately cited 18 unique medical papers in addition to other sources in this appeal, but had found and used more during my research and writing.)

Don’t assume that your health insurer stays up-to-date on the latest and greatest. Their medical policies are periodically updated but, if the insurer really doesn't want to pay for a medical service, they’re unlikely to perform an objective, complete literature analysis. No doubt they’ll keep up appearances; policies are chock full of academic language, medical terminology, and citations. (Check my other post for more about these policies). You need your own education, analysis, and sources to prove that the literature supports your arguments.

By the way, medical providers are incredibly busy professionals who do not always have the time to punctually read every new paper in their field. If you use Inciteful Med to explore your own health, you may find yourself tactfully recommending a good read to your care team. In general, Inciteful Med also includes many features I haven't mentioned, so I encourage you to check it out for yourself.

You Can Do It

I often use this header to conclude posts, and it’s true. When I start working with patients who retain my professional patient advocacy services, they’re often frustrated, overwhelmed, or angry. They feel trapped in a Rube Goldberg machine. But applications such as Inciteful Med help level the playing field and advance the cause of patient advocacy.