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Auxilary Aids & Services

For information about the availability of beneficiary auxiliary aids and services, please call our Beneficiary Contact Center at 800-833-4455.

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Railroad Medicare
Appeals

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

New toll-free SMAC number effective 7/1/15



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Instead of a Written Redetermination: Consider Having Your Claim Reopened07/01/2015
Can we submit an appeal if we disagree with an Medically Unlikely Edit (MUE) denial?06/16/2015
If my claim is denied for failure to submit requested documentation within 45 days of an Additional Documentation Request (ADR), should I submit a new claim and attach the requested documentation with the new claim?06/10/2015
Checklist for Timely Filing Extension03/30/2015
Prevent Duplicate Appeal Requests03/12/2015
Signature Requirements for Redetermination Requests: Reminder03/03/2015
Redetermination Request Form for Railroad Medicare Claims11/13/2014
Railroad Medicare Accepts Faxed Redetermination Requests11/09/2014
Redeterminations: What Information Should I Send with Faxed, Online, or Mailed Requests Submissions11/09/2014
General Appeals Information10/21/2014
Calendar Year 2015 Update: Amount in Controversy Requirements for Administrative Law Judge (ALJ) and Federal District Court Appeals10/20/2014
Redetermination Time Limit: Reminder10/09/2014
Medicare Medical Records: Signature Requirements, Acceptable and Unacceptable Practices08/12/2014
More Appeals Forms Now Available in Online Provider Services (OPS)05/20/2014
Chapter 29 Appeals Update (Includes Post-DOMA Guidance and Signature Requirement for Appointment of Representatives and Assignment of Appeal Rights)Open in New Window04/18/2014
Railroad Medicare Accepting Appeal Requests Through Our Online Provider Services (OPS) Tool11/15/2012
Medically Unlikely Edits (MUE)11/09/2012
Redetermination Status Tool Now Available Online03/20/2012

 

last updated on 7/01/2015
ver 1.0.51