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Auxilary Aids & Services

For information about the availability of auxiliary aids and services, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html

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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 this form to the Qualified Independent Contractor (address is located on form).


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Calendar Year 2015 Update: Amount in Controversy Requirements for Administrative Law Judge (ALJ) and Federal District Court Appeals10/20/2014
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?09/11/2014
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
Signature Requirements for Redetermination Requests: Reminder04/07/2014
Prevent Duplicate Appeal Requests01/15/2014
General Appeals Information12/11/2013
Redetermination Time Limit: Reminder10/09/2013
Instead of a Written Redetermination: Consider Having Your Claim Reopened01/24/2013
Railroad Medicare Accepting Appeal Requests Through Our Online Provider Services (OPS) Tool11/15/2012
Medically Unlikely Edits (MUE)11/09/2012
Railroad Medicare Accepts Faxed Redetermination Requests11/09/2012
Redetermination Request Form for Medicare Railroad Claims11/09/2012
Redeterminations: What Information Should I Send with Faxed, Online, or Mailed Requests Submissions11/09/2012
Redetermination Status Tool Now Available Online03/20/2012

 

last updated on 11/01/2014
ver 1.0.51