Upcoming Webinars

  • No upcoming events


The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Log in

Medicare Appeals 

Denials by Medicare are on the rise.  Congress and the Office of Inspector General have both called for increased scrutiny over Part A and B Medicare claims.  Reduced payments to Medicare Advantage Plans have caused the plans to take a more hardline approach to claims approvals and denials.  Providers’ main tool to combat these denials is the appeals process.  This article will give an overview of the Part A and Part B appeals process as well as the Part C appeals process for Medicare Advantage Plans.  

Live Webinars

Medicare Appeals 12:00 - 1:00 CDT on April 17, 2019

Medicare Appeals 12:00 - 1:00 CDT on April 18, 2019

Levels of Appeals and Time Limits for Filing

Good Cause for Late Filing

Decisions Subject to Appeal

Who May File

Appointing a Representative

Level 1: Redetermination

Level 2: Reconsideration

Level 3: ALJ Hearing

Level 4: Appeals Council Review

Level 5: Judicial Review

Medicare Advatage Appeals

Copyright Med Comply LLC 2020

Med Comply does not claim copyright over US Federal and State materials

CPT codes are copyright 1995-2020 American Medical Association. All rights reserved.

Powered by Wild Apricot Membership Software