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Appeal

A formal request to your insurance company to review a decision they made, such as denying a claim or pre-authorization.

Detailed Explanation

If you believe your insurance company has made an incorrect decision about your healthcare coverage, you have the right to file an appeal. The process usually involves submitting documentation and following the insurer's guidelines.

Practical Example

Maria's insurance company initially denied her claim for a necessary physical therapy treatment. Her doctor helped her gather the required documentation, and she filed an appeal. After review, the insurance company overturned their initial decision and approved the coverage.

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