Insurance appeal evidence, cited in the letter.

Answer a denial with the evidence. Vero finds the guidelines and trials behind the treatment, then drafts the appeal from the chart, each source cited in the body.

Draft an appeal free See the evidence

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Prior authorization deniedSemaglutide 0.5 mg weeklyNot medically necessary: A1C at goal

Searching guidelines and trials

9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026Clinical guideline · ADA 2026diabetesjournals

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 DiabetesRandomized trial · 3,297 patientspubmedL1

Appeal letterDraft

I am appealing the denial of semaglutide for R. Patel, who had a heart attack in 2024.

The ADA recommends a GLP-1 RA with proven cardiovascular benefit in ASCVD, independent of A1C. diabetesjournals

In SUSTAIN-6, semaglutide cut major cardiovascular events by 26%. pubmedL1

An appeal letter, built from the chart.

In the visit’s Chat, turn Research on and ask. Vero writes the letter as a note tab.

Research on
R. Patel

Create an appeal letter for the semaglutide denial.

Added a note tab

Visit note
Appeal letter

Appeal letterTo: Health plan, utilization review

1The request, and the decision being appealed

I am appealing the denial of semaglutide 0.5 mg weekly for my patient, R. Patel. The denial states it is not medically necessary because her A1C is at goal.

2The patient’s history, from the chart

Ms. Patel is 61, with type 2 diabetes since 2016. She had a myocardial infarction in 2024, treated with a stent, and has hypertension and dyslipidemia.

3What was tried before

She takes metformin 1,000 mg twice daily. Empagliflozin was stopped after recurrent genital infections.

4The evidence, cited

The ADA recommends a GLP-1 receptor agonist with proven cardiovascular benefit for type 2 diabetes with established atherosclerotic cardiovascular disease, independent of A1C. diabetesjournals

In SUSTAIN-6, semaglutide lowered cardiovascular death, nonfatal heart attack, or nonfatal stroke by 26% versus placebo. pubmedL1

5The ask

Please approve semaglutide for cardiovascular risk reduction. I am available for a peer-to-peer review.

The evidence for three common denials.

Biologic for psoriasis

A biologic after methotrexate

The psoriasis guideline, and the trial that compared the two head to head.

Adalimumab deniedStep therapy: methotrexate trial not shown

Evidence for adalimumab after methotrexate failed?

AAD-NPF guidelines recommend adalimumab for moderate-to-severe plaque psoriasis. jaad

Head to head, 79.6% reached PASI 75 at 16 weeks on adalimumab, against 35.5% on methotrexate. pubmedL1

Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologicsClinical guideline · AAD and NPF 2019jaad
Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION)Randomized trial · 271 patientspubmedL1

CGM deniedNot medically necessary

Evidence for CGM on basal-bolus insulin?

The ADA recommends CGM for adults with diabetes on insulin, type 2 included. diabetesjournals

In adults with type 2 diabetes on multiple daily injections, CGM lowered A1C more than usual care. pubmedL1

7. Diabetes Technology: Standards of Care in Diabetes-2026Clinical guideline · ADA 2026diabetesjournals
Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections: A Randomized TrialRandomized trial · 158 patientspubmedL1

Teriparatide deniedStep therapy: bisphosphonate first

Evidence for teriparatide after two vertebral fractures?

ACP suggests teriparatide or romosozumab, then a bisphosphonate, for women at very high fracture risk. acpjournals

Against risedronate, teriparatide cut new vertebral fractures from 12.0% to 5.4%. pubmedL1

Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of PhysiciansClinical guideline · ACP 2023acpjournals
Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trialRandomized trial · 1,360 womenpubmedL1

Find evidence for your appeal

Free to start. No credit card required.

What a reviewer looks for first.

The guideline recommendation

The issuing body, the year, and the recommendation that covers this patient, cited in the sentence that makes the case.

diabetesjournalsacpjournals

Prior treatments, documented

What was tried, at what dose, and why it stopped, taken from the chart with the patient attached.

Metformin 1,000 mg twice daily
Empagliflozin, stopped

Trial evidence

The design, the size, and the outcome that matters, with its level of evidence.

pubmedL1

The patient’s specifics

The diagnoses, the severity, and the labs or scores the plan’s criteria name.

Type 2 diabetes
Heart attack, 2024
A1C 6.9%

Write a cited appeal free

10 free actions every month.

Then the prior authorization form

Vero Chat fills PDF form fields from the visit. State, insurer, and pharmacy benefit forms are in our US forms library.

Browse prior authorization forms

Patient privacy, built in from the start.

Every visit is protected health information, and Vero handles it that way from the first word to the final note.

HIPAACompliant
SOC 2Type II

Audited compliance

SOC 2 Type II certified. HIPAA compliant.

No audio kept

Recordings are used to write the note and are never stored.

Never used for training

Your patients’ data is never used to train AI models.

Your retention rules

Notes auto-delete after 1 to 365 days, on your schedule. Multi‑factor sign-in included.

Insurance appeals, answered.

What evidence do insurers look for in an appeal?

Usually the guideline recommendation that covers the patient, the treatments already tried and why they stopped, trial evidence for the option requested, and the patient’s specifics, such as severity scores and labs.

Can Vero write a letter of medical necessity?

Yes. In the visit’s Chat, turn Research on, attach the patient, and ask for an appeal letter. Vero drafts it as a note tab with citations in the body, ready for you to review and edit.

Does the letter use the patient’s chart?

With the patient attached, Vero considers their history, medications, allergies, and prior encounters on file, so past treatments and the patient’s specifics come from the record.

Which sources can an appeal cite?

Clinical practice guidelines, systematic reviews and meta-analyses, randomized trials, peer-reviewed journals, and authoritative drug references. Each citation links to its source.

Does it work for special authorization in Canada?

Yes. Ask for a special authorization request or a private insurer appeal, and include your province so the letter cites the guidance that applies there.

Can Vero fill in the prior authorization form too?

Vero Chat fills PDF form fields from the visit. Our forms library collects US prior authorization forms and Canadian insurance forms.

US prior authorization forms Canadian insurance forms

How do I send the letter?

Download, print, or email it from the visit, like any note.

Is it included in the free plan?

Yes. Every Vero plan includes Vero Evidence. The free plan comes with 10 actions a month and no credit card; Pro is unlimited.

See plans

Answer the denial with the evidence.

A cited appeal letter, drafted from the chart in the visit’s Chat.

Draft your first appeal free

No credit card required. 10 free actions every month.