US Medical Term · insurance
Internal Appeal
Apelación Interna
In 9 languages
| Language | Term |
|---|---|
| English | Internal Appeal |
| Spanish (Español) | Apelación Interna |
| Chinese (中文) | 内部申诉 |
| Korean (한국어) | 내부 이의 신청 |
| Vietnamese (Tiếng Việt) | Kháng cáo nội bộ |
| Filipino (Tagalog) | Internal Appeal |
| Portuguese (Português) | Recurso interno |
| Thai (ภาษาไทย) | การอุทธรณ์ภายใน |
| Japanese (日本語) | 内部異議申し立て |
What it means
An internal appeal is a formal request you submit to your health insurance plan asking it to reconsider a denial of coverage, prior authorization, or payment. It is the first required step in the appeals process—you must generally exhaust internal appeals before seeking an external review by an Independent Review Organization. Federal law requires plans to decide standard internal appeals within 30 days for pre-service decisions and 60 days for payment disputes. Urgent or expedited appeals must be resolved within 72 hours. During the appeal, you can submit supporting documents—physician letters, medical records, clinical guidelines—that strengthen your case. Keep copies of everything you submit.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
file an internal appeal with your insurer
presentar una apelación interna a su asegurador
first-level coverage appeal
apelación de cobertura de primer nivel
plan-level appeal of a denial
apelación a nivel del plan de una denegación
Where you'll see it
Related terms
Sources
Last reviewed: September 2026