Medical billing dispute history (Brazil)

Five years of insurer billing disputes, denial reasons, appeal letters and settlement outcomes from a Brazilian outpatient clinic network.

Private insurers in Brazil regularly deny or reduce clinic claims, and billing teams spend many hours contesting them. This history tracks about 190,000 of those disputes at Marimba Health across five years. Each case holds the procedure code, billed amount band, denial reason, appeal text, insurer response and final result. Denial reason codes are the natural labels, while the appeal letters show how staff argue a case. We also calculate days to resolution and whether the amount was recovered in full, in part or not at all. Insurers are coded, so you can compare behavior without seeing names. Appeal letters occasionally include clinical justification, so we consider this data highly sensitive. Direct identifiers were removed, but small clinics and rare procedures could carry some re-identification risk, and we would discuss that before any release. Letters before 2021 were scanned, and their OCR quality is uneven.