If your insurance company initially denies a medical claim, you have a right to appeal their decision. Under federal law, you are entitled to an “internal appeal” and an “external review.” In both instances, the insurance company must re-visit their decision to deny the claim and provide you with a clear, impartial justification for their decision. The appeals process can be confusing. If you are seeking urgent medical care and need prior approval, you may be entitled to an “expedited review” by your insurance company. If you request expedited review the company must complete the process and give you a decision within 72 hours of the request. We put together a fact sheet explaining how both appeals work.