Palmetto GBA
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Jurisdiction 1 Part B
Appeals

 Access information regarding your appeal rights on the Palmetto GBA Appeals page:
  • Avoid future appeals by submitting claims accurately: use the Denial Finder tool
  • Some denials can be adjusted via telephone reopening 
  • Appeals forms are located on this page. You may complete the forms electronically then print and sign the forms, attach supporting documentation, and mail to the address indicated on the forms.
  • First level of appeal: redetermination. Timeframe: 120 days from the date of the initial determination. Services that are 'rejected as unprocessable' with remark code MA130 must be corrected and resubmitted, and not appealed.
  • Second level of appeal: reconsideration. Timeframe: 180 days from receipt of Redetermination. Submit this form to the Qualified Independent Contractor. The address is located on form.

Change in the Amount in Controversy Requirement for Administrative Law Judge Hearings and Federal District Court Appeals06/10/2010
General Appeals Information06/09/2010
Medicare Appeals: The Importance of Getting It to the Right Place at the Right Time01/15/2010
Using the Redetermination/Reopening Request Form12/09/2009
Request for Part B Redetermination or Reopening Form07/23/2009
Redeterminations: What information should I send with the request?07/22/2009
Reopenings (Claim Corrections) and Appeals: Tips for Faster Service10/02/2008
Telephone Claim Correction Checklist09/19/2008
Second Level Appeal Request: J1 Part B Reconsideration Form09/12/2008
First Level Appeal Request: J1 Part B Redetermination/Reopening Request09/03/2008

 

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last updated on 06/10/2010
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