Access information regarding your appeal rights and learn more on submitting an appeal request on the Palmetto GBA Appeals page:
- Some denials can be adjusted via telephone reopening
- You may submit your appeal request in writing or through our website using Online Provider Services (OPS)
- Railroad Medicare also accepts redetermination requests via fax at (803) 462-2218
- First level of appeal: redetermination. Timeframe: 120 days from the receipt of the initial determination. The notice of initial determination is presumed to be received 5 days from the date of the notice.
- 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 (see above). Submit the CMS 20033a form to the Part B South Qualified Independent Contractor (QIC). Information about the QIC can be found on the C2C website.