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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




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