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Compliance Enforcement Deadline
03/31/2012 11:59pm

2012-03-31 23:59:00 GMT-05:00
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Jurisdiction 11 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 Resolution tool
  • Some denials can be adjusted via telephone reopening, please call (877) 872-5556
  • 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 on the form.
  • First level of appeal: redetermination. Time frame: 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. Time frame: 180 days from receipt of Redetermination (see above). Submit this form to the Qualified Independent Contractor (address is located on form).

Fax number for J11 Part B redetermination requests: (803) 699-2427

You may also mail redetermination requests to:
Palmetto GBA Part B – J11 MAC, AG-655
P.O. Box 100190
Columbia, SC 29202-3190


Calendar Year 2012 Updated: Amount in Controversy Requirements for Administrative Law Judge (ALJ) and Federal District Court Appeals12/21/2012
Appeals Tip of the Month: Avoid Processing Delays and Send the Overpayment Demand Letter With Your Appeal Request01/19/2012
General Appeals Information12/20/2011
J11 Part B Redetermination Requests10/25/2011
Instead of a Written Redetermination: Consider Having Your Claim Reopened06/24/2011
Guidelines to Allow Contractors to Develop and Utilize Procedures for Accepting and Processing Reopenings via a Secure Internet Portal/Application06/22/2011
2nd Level Appeals: Qualified Independent Contractor (QIC) For Reconsiderations03/01/2011
Appeals Process: Levels and Exceptions03/01/2011
Guidelines to Allow Contractors to Develop and Utilize Procedures for Accepting and Processing Appeals via Facsimile and/or via a Secure Internet Portal/Application03/01/2011
Redetermination Time Limit: Reminder03/01/2011
Second Level of Appeal: Reconsideration Request Forms03/01/2011
Appeal Rights: Know the Rules02/25/2011

 

last updated on 2/01/2012
ver 1.1.1