Win two UnitedHealthcare coverage fights over about three months with ChatGPT

Posted

Dec 13, 2025 by Austin Oehlerking (LinkedIn)

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Last checked

Oct 18, 2026

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Method:

How we verify

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

Outcome

Austin Oehlerking says they used ChatGPT 5.1, with Gemini for some confirmations, to fight UnitedHealthcare twice in one year, for prescription coverage (Wegovy) and for durable medical equipment (a CPAP machine), after coverage was denied or refused several times. It took nearly three months. They say the AI helped decode policy language, draft evidence-based appeals, set out next steps and supply firm rebuttal wording; they won coverage both times.

Agent

ChatGPT, Gemini

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: Help me challenge a health insurance denial step by step until I get a final answer.

What I'll share as we go:
- The denial letter and reason code (I'll hide ID numbers)
- The relevant parts of my plan document
- What my doctor or supplier has sent so far
- 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:
- Explain the denial and the plan language in plain words.
- Tell me what evidence the plan says it needs and which I already have.
- Draft appeal letters only from my documents and the plan wording, quoting the plan where it helps.
- Keep a timeline of calls, letters, reference numbers and deadlines.
- Suggest firm, polite wording when I'm pushed back.
- 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 plain explanation, a draft appeal with an attachment list, and a running timeline.

You'll know it worked when: the insurer approves coverage in writing, or I know the next level of appeal and its deadline.

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: Help me challenge a health insurance denial step by step until I get a final answer.

What I'll share as we go:
- The denial letter and reason code (I'll hide ID numbers)
- The relevant parts of my plan document
- What my doctor or supplier has sent so far
- 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:
- Explain the denial and the plan language in plain words.
- Tell me what evidence the plan says it needs and which I already have.
- Draft appeal letters only from my documents and the plan wording, quoting the plan where it helps.
- Keep a timeline of calls, letters, reference numbers and deadlines.
- Suggest firm, polite wording when I'm pushed back.
- Check facts that can change (prices, opening hours, dates, availability, rules) against the official source, and tell me anything you couldn't verify.
- Remind me of every deadline a week before it's due.

Output: A plain explanation, a draft appeal with an attachment list, and a running timeline.

You'll know it worked when: the insurer approves coverage in writing, or I know the next level of appeal and its deadline.

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://www.linkedin.com/posts/austinoehlerking_ive-now-used-ai-twice-to-successfully-fight-activity-7405440497093095424-VJv1