Appeal

What does Appeal mean on a medical bill?

An appeal is a formal request for your plan to look at a denied claim again. The first round is internal, decided by the plan itself, and it is normally required before any outside review. Every plan sets its own deadlines and its own filing instructions, and they vary enough that guessing is a bad idea — ask for them in writing. What moves an appeal is evidence: the records, a letter from the doctor, and the plan's own criteria quoted back at it. A phone call alone rarely changes anything.

What should I watch out for with Appeal?

• Ask your plan for its appeal instructions and its deadline in writing, since both vary by plan
• Send the records and the doctor's letter with the appeal, not just a copy of the bill
• Keep the date, the name, and the reference number from every call in one place