How to File an Appeal
ASK RUBY: How to File an Appeal
If your health insurance provider denies all or partial coverage for a claim, you can consider filing an appeal.
An appeal is a request to review a health insurance provider's decision regarding a claim. A claim is a request for payment for health services submitted to your insurance provider.
Many health insurance plans permit internal and external appeals. An internal appeal is filed first and requests that your insurance provider takes another look at their decisions on your claim. An external appeal is filed second, to an external source, so they can review your insurance provider's decision to deny your claim.
The amount of time you have to file an appeal and the time by which you hear back from your provider with the decision regarding your appeal varies among health insurance provider types, including private insurance, Medicare, and Medicaid.
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