Definition
A formal request to your insurance company to review and reconsider a denied claim or coverage decision. You have the right to appeal any denial. Internal appeals go to the insurer; external appeals go to an independent review organization. Many denied claims are overturned on appeal — always appeal significant denials.
Related Terms
- Deductible
The amount you must pay out of pocket for covered healthcare services before you...
- Copay
A fixed amount you pay for a covered healthcare service after you have met your ...
- Coinsurance
Your share of the costs of a covered healthcare service, calculated as a percent...
- Out-of-Pocket Maximum
The most you have to pay for covered services in a plan year. After you spend th...
- Premium
The amount you pay each month for your health insurance coverage, regardless of ...
Understanding healthcare terminology helps you communicate more effectively with providers and make informed decisions about your care. Use our procedure cost database to find fair prices for any medical service.