Question

What is the purpose of the appeals process?

Is it an effective process? Provide details and examples

Answer 1

Appeal process allows a loosing party in trial court decision to have their case retried again. No additional evidence is provided to the appellate court and no witnesses may be heard. The entire process is based on record of the case as heard in prior court decision .

Purpose - appeal process function both as process for error correction and process of clarifying interpreting laws.

When a claim is down coded, reduced or denied , appeals process can be used for challenging the payers decision. Patient and provider both have right and ability to appeal. For example should a claim is denied for the reason of missing signature. The claim has to be corrected with missing signature.

Appeal process may be active or canceled. If active then appeal process is effective.

Appeal process is basically an effective process. Because there are many cases in which patient or people are denied by provider. In that process it is effective.

Cases which are denied due to missing signature or any other small formality, then effective process.

If people or patient is not satisfied then appeal process is effective.