Some physician practices don't routinely audit and appeal inappropriately paid or denied health plan claims because they believe it will create an increased administrative burden on the practice. However, not appealing such claims can be quite costly to your practice, according the American Medical Association. Here's why:
- You may lose revenue.
- You may lose the opportunity to recover overhead expenses if you don't have a smooth claims management process.
- You may lose more revenue later, through future denials. But when you challenge inappropriate claim payments, you show your practice is making an effort to correct the plan's inaccuracy. This could lead to a positive change in the health plan's business practices.
View TMA's Claims Appeal Reference Guide to learn more about the claims appeal process.
If you need more help appealing your claims, TMA’s Physician Payment Resource Center (PPRC) goes to bat for members by helping resolve insurance payment issues. Learn about this free member service.
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Last Updated On
September 16, 2026
Originally Published On
March 23, 2010