Appeal in Medical Billing
An appeal in medical billing is the process of formally challenging a denied or underpaid claim with the insurance company.
Appeal in Medical Billing Explained
When a claim is denied or reimbursement is less than expected, providers or patients can file an appeal to request a review and reconsideration of the payer’s decision. The appeal includes documentation to support the claim, such as medical records or a letter explaining why the service should be covered.
For example, a provider submits an appeal to the insurance company after a medically necessary surgery is denied, including documentation showing why the procedure was essential.
Explore acronyms and abbreviations in Medical billing glossary.
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