US Medical Term · insurance
Appeals Process
Proceso de apelación
In 9 languages
| Language | Term |
|---|---|
| English | Appeals Process |
| Spanish (Español) | Proceso de apelación |
| Chinese (中文) | 申訴程序 |
| Korean (한국어) | 이의 제기 절차 |
| Vietnamese (Tiếng Việt) | Quy trình kháng cáo |
| Filipino (Tagalog) | Proseso ng apela |
| Portuguese (Português) | Processo de apelação |
| Thai (ภาษาไทย) | กระบวนการอุทธรณ์ |
| Japanese (日本語) | 異議申し立てプロセス |
What it means
The appeals process is the formal procedure for challenging an insurance company's denial of a claim or a request for coverage. If your insurer denies payment for a service or medication, you have the right to appeal. There are typically two levels: an internal appeal reviewed by the insurer and an external appeal reviewed by an independent organization. You generally have 180 days from receiving a denial to file an internal appeal. Time limits for the insurer to respond vary. The ACA requires all non-grandfathered health plans to provide these rights. Keeping records of all communications is important throughout the process.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
I want to file an appeal for the denied claim on my account.
Quiero presentar una apelación por el reclamo denegado en mi cuenta.
What is the deadline to submit an appeal for this denial?
¿Cuál es el plazo para presentar una apelación por esta denegación?
Can you escalate my case to an external review if the internal appeal is denied?
¿Pueden escalar mi caso a una revisión externa si se deniega la apelación interna?
Where you'll see it
Related terms
Sources
Last reviewed: September 2026