Appeal
Appeal (əˈpēl)
Appeal is a term used in the medical field, often in the context of health care services and patient rights. It refers to the process of formally requesting a review of a decision or finding, particularly in relation to health insurance coverage or medical treatment decisions.
Etymology
The term 'appeal' originates from the Old French apeler, meaning 'to call upon'. It was later adopted into Middle English as apelen, and has been used in the legal and medical context since the 14th century.
Definition
In the medical context, an appeal is a formal request made by a patient or a healthcare provider to a health insurance company or a healthcare institution to review and reconsider a decision made about the healthcare services, treatments, or benefits.
Process
The appeal process typically involves the following steps:
- The patient or healthcare provider submits a written request for an appeal, detailing the reasons for disagreement with the initial decision.
- The insurance company or healthcare institution reviews the appeal, which may involve a thorough examination of the patient's medical records, the treatment plan, and the reasons provided in the appeal.
- A decision is made, either upholding the original decision or overturning it in favor of the appellant.
Related Terms
- Health Insurance: A type of insurance coverage that pays for medical and surgical expenses incurred by the insured.
- Patient Rights: The basic rules of conduct between patients and medical caregivers.
- Medical Records: A systematic documentation of a patient's medical history and care.
- Treatment Plan: A detailed plan with information about a patient's disease, the goal of treatment, the treatment options for the disease and possible side effects, and the expected length of treatment.
External links
- Medical encyclopedia article on Appeal
- Wikipedia's article - Appeal
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