Insurance companies deny coverage for nerve repair procedures for several reasons. The most common are:

• Investigational or experimental: Some insurers have historically classified nerve allograft as investigational, even though Avance Nerve Graft received full FDA approval as a biologic in December 2025. Insurer policies don't always reflect the latest regulatory decisions, and outdated criteria are one of the most common reasons for denial.
• Not medically necessary: Your insurer may claim that nerve repair isn't required for your condition, or that an alternative approach (such as autograft — using nerve tissue harvested from another part of your body) should be used instead.
• Plan exclusion or coverage limitation: In some cases, your specific insurance plan may have restrictions on coverage for certain procedures or products.

If your denial letter uses language you don't understand, you're not alone — denial letters are often written in confusing, clinical terms. That's part of what Claimable helps with.

A denial is not a final decision — it's the start of a process. You have the legal right to appeal, and appeals can be successful.

Here's what to do:

1. Read your denial letter carefully. It will include the specific reason your claim was denied and instructions for how to appeal. Keep this letter — you'll need it.
2. Note the deadline. Your denial letter will include a deadline for filing an appeal. Mark it and don't miss it.
3. Talk to your surgeon's office. Let them know you've been denied. They may also be working on an appeal or peer-to-peer review on their end.
4. Start your appeal with Claimable. Through this program, you can create and submit an evidence-based patient appeal at no cost to you. You'll answer some questions about your health and situation, and Claimable will generate a personalized appeal that includes clinical evidence, policy arguments, and your personal story.

The most important thing is to act quickly — especially if you have a surgery date scheduled.

It depends on the type of appeal and your specific situation, but here's what to expect:

• Urgent/expedited appeals: If your appeal is related to a scheduled surgery or a time-sensitive medical situation, it can be classified as urgent. Federal law requires insurers to respond to urgent appeals within 72 hours, and in some cases within 24 hours. Through this program, Claimable will help you flag your appeal as urgent when appropriate.
• Standard internal appeals: Insurers are generally required to respond within 30 days for pre-service denials (before you've had the procedure) and 60 days for post-service denials.
• External review: If your internal appeal is denied, you have the right to an independent external review. These are typically decided within 45–60 days, or faster for urgent cases.

Claimable's platform is designed to get your appeal submitted quickly — most patients complete the process in about 30 minutes. From there, the timeline depends on your insurer's response.

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Not necessarily. If your surgery is already scheduled, time is critical — and that's exactly why the appeal process includes an expedited option.

When an appeal is filed as urgent, your insurer is required by law to respond within 72 hours (and in some cases, 24 hours). Claimable will help you file an expedited appeal and clearly communicate the time-sensitive nature of your situation.

That said, every case is different. We recommend:

• Letting your surgeon's office know you've been denied and that you're appealing. They can help coordinate timing.
• Starting your appeal immediately. The sooner you file, the more time your insurer has to respond before your scheduled date.
• Do not cancel your surgery before talking to your care team. In some cases, your surgeon may recommend proceeding with the surgery while the appeal is in progress, depending on your specific medical and insurance situation.

AVANCE (acellular nerve allograft-arwx) is an FDA-approved biologic used to repair damaged or severed nerves. It's made from donated human nerve tissue that has been specially processed.

Your surgeon may recommend AVANCE when a nerve has been damaged and needs a "bridge" to reconnect the healthy nerve ends. Unlike autograft — where nerve tissue is taken from another part of your body, creating a second surgical site — AVANCE is an off-the-shelf graft that doesn't require harvesting your own tissue.

AVANCE is used in several types of nerve repair, including breast nerve reconstruction (restoring sensation after mastectomy), head and neck reconstruction, extremity nerve repair, and other procedures where nerve function needs to be restored.

In December 2025, the FDA approved AVANCE as a biologic product to treat peripheral nerve discontinuities.

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Axogen is the medical technology company that developed Avance nerve allograft. Axogen's mission is to restore health and improve the quality of life by making the restoration of peripheral nerve function an expected standard of care.

Axogen has partnered with Claimable to provide this no-cost appeal service for eligible patients who have been denied insurance coverage for nerve repair procedures using Avance Nerve Graft. Through this partnership, you can access Claimable's appeal platform to create and submit a personalized, evidence-based appeal — at no cost to you.

Through this partnership with Axogen, there is no cost to you for using Claimable to create and submit your appeal.*

You'll have access to Claimable's full appeal platform — including personalized appeal generation, evidence-based arguments, and submission via fax and mail — at no charge. See program terms for full details.

To create your appeal, you'll need:

• Your denial letter — this tells us exactly why your claim was denied, which insurer denied it, and what your appeal deadlines are. If you don't have a physical copy, you may be able to find it through your insurer's online portal or mobile app.
• Your insurance card — you can take a photo of the front and back.
• Basic information about your health situation — Claimable will walk you through guided questions about your condition, treatment history, and how the denial has affected you. You don't need to prepare anything in advance.

If you have any additional documentation — such as a letter of medical necessity from your surgeon, medical records, or test results — you can upload those too, but they're not required to get started.

The entire process typically takes about 30 minutes.

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They may be — and that's a good thing. Provider appeals and patient appeals work together, and having both strengthens your case.

Here's how they're different:

• A provider appeal is filed by your surgeon or their office. It typically focuses on the clinical rationale for why your procedure is medically necessary, and may include a peer-to-peer review with the insurer's medical reviewer.
• A patient appeal is filed by you (with Claimable's help). It includes your personal health story, clinical evidence matched to your specific situation, analysis of your insurer's own coverage policies, and references to applicable laws and regulations. Patient appeals also trigger additional legal protections — including mandated response timelines, the right to an independent external review, and access to the insurer's internal criteria.

You don't need to wait for your provider's appeal to be resolved before filing your own. In fact, filing both at the same time can create more pressure on the insurer to reconsider. Even if your surgeon has already done a peer-to-peer, a patient appeal gives you additional levels of review and brings in arguments that a provider appeal can't.

We recommend letting your surgeon's office know that you're filing a patient appeal so they can coordinate with you.