Definition. When an insurance plan does not pay for treatment, an appeal (either by the provider or patient) is the process of objecting this decision. The insurer may require documentation when processing an appeal and typically has a formal policy or process established for submitting an appeal. Many times the process and associated forms can be found on the insurance providers web site.
You'll come across Appeal while working the revenue cycle — from eligibility and claim submission to payment posting and denials. See the related terms below, or browse the full glossary and the Knowledge Hub.