Palmetto GBA
^ Back to Top
Close Window [x]
  • Entire Site
  • J1 Part A
  • J1 Part B
  • J11 HHH
  • J11 Part A
  • J11 Part B
  • NSC
  • Railroad
+
SubHomeHeader


Stay Connected
Keep up with the latest information about Palmetto GBA by taking advantage of the Internet's connectivity.
 

Bookmark E-mail Print Digg It! Tweet FB Like Show/Hide Google+ line
Standard Font Serif Font Decrease Font Size Increase Font Size
permaLink

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


Search this Area Search this Area
Second Level of Appeal: Reconsideration Request Form05/20/2013
Claim Reopenings Web Based TrainingOpen in New Window05/16/2013
Calendar Year 2013 Update: Amount in Controversy Requirements for Administrative Law Judge (ALJ) and Federal District Court Appeals05/10/2013
General Appeals Information05/10/2013
Alert: Redetermination Requests Are Inappropriately Being Sent to the Medical Review Department and Cannot be Forwarded to the Appeals Department for Processing05/06/2013
Hints for Submitting Medical ADR (Additional Documentation Requests) or Appeal Requests05/06/2013
Prevent Duplicate Appeal Requests02/15/2013
J11 Part B Redetermination Requests01/09/2013
Appeals Tip of the Month: Avoid Processing Delays and Send the Overpayment Demand Letter With Your Appeal Request12/01/2012
Redetermination Time Limit: Reminder11/09/2012
Redetermination Status Tool Available Online10/18/2012
Instead of a Written Redetermination: Consider Having Your Claim Reopened10/16/2012
When to Request a Redetermination or a Reopening: Reminder06/19/2012
Prevent Duplicate Appeal Requests05/03/2012
Telephone Reopening Tips04/26/2012
Appeal Rights: Know the Rules03/08/2012
Calendar Year 2012 Updated: Amount in Controversy Requirements for Administrative Law Judge (ALJ) and Federal District Court Appeals12/21/2011
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

 

last updated on 5/01/2013
ver 1.0.37