Health

Nilsa Cruz on helping patients appeal health claim denials

Milwaukee Rheumatology Center patient advocate Nilsa Cruz describes using software to help patients tell their individual stories and cite medical evidence when appealing health plan claim denials.

By Marisa Wojcik | Here & Now

August 13, 2025

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Nilsa Cruz on using software to help patients appeal health plan claim denials.


Nilsa Cruz:
I'm constantly looking for ways to make it easier for my patients to appeal. I use Claimable. Through Claimable, the patient tells their story, I put in my letter of medical necessity, or Dr. Rosler's letter of medical necessity, with the denial. And Claimable will actually bring the legalese in patients' words that is necessary with proven studies, prior overrides nationwide, all into one beautifully crafted letter that has this much of a patient's story in there — huge. And then, we send it to key players. It has helped me and my patients expose the health care inequities that are currently in our system.