1. Rejection of a medical service due to insurance coverage policy or insurance program issues. 2. Rejection of all or part of an insurance claim. Application of contractual copayments and deductibles is not considered a denial of a claim. 3. Official Medicare decision that services will not be approved for payment. This may be due to a decision that the service is not an approved service, not being provided in the proper setting for the level of care, not provided by an approved participating provider, or not medically necessary.