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© 2021 Palmetto GBA, LLC

We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.

Published Date:04/20/2016

Printed Date: 9/22/2015

URL: http://palmgba.com/marlowe/redesign6/article.html


Appeals

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Submitting an appeal: 

  • Providers are encouraged to submit their appeals via Palmetto GBA's eServices portal
  • By using eServices, providers can submit the appeal request and the complete medical record online
  • Once submitted, you will receive a confirmation from Palmetto GBA indicating that the appeal has been received
  • For more information please review the Appeals section in the eServices manual
  • You may also complete the forms electronically on our website
    • Please include your first and last name. You can then print the form.
    • Attach the complete medical record and mail to the address indicated on the form. The appeals form can be found on our website
  • First level of appeal: redetermination. Timeframe: 120 days from the date of the initial determination. Services that are "returned to provider" with remark code MA130 must be corrected and resubmitted, not appealed.
  • Second level of appeal: reconsideration. Timeframe: 180 days from receipt of redetermination. Submit this form to the Qualified Independent Contractor.

Appeal Letters

  • Appeal letters  are sent with the results for partially paid services and denied services

Status Lookup Tools

  • Appeals Status Tool
  • Administrative Law Judge (ALJ) (Third Level) Status Lookup Tool: HHS.gov website

Jump to:


Latest Articles

      

eServices Appeals Feature 02/06/2021
Fax Number, Address, and Correct Format for Submitting Redeterminations 02/06/2021
C2C Innovative Solutions, Inc.: Qualified Independent Contractor (QIC) for Part A East Jurisdictions 01/22/2021
Guide to Understanding the Limitation of the Scope of Review on Redeterminations and Reconsiderations of Certain Claims 01/22/2021
Maximus Federal Services, Inc. Is the Qualified Independent Contractor (QIC) for the Part A West Jurisdiction 01/22/2021
Provider Adjustments Denied for Medical Necessity or After an Appeal Has Been Submitted 01/22/2021
Appeals Overview for Providers Module Open in New Window12/21/2020
General Appeals Information 10/06/2020
Notification of the 2021 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review 10/06/2020
Medicare Redetermination Notices Mailing Address 09/14/2020
Medicare Parts A and B Appeals Process CMS Fact Sheet Open in New Window06/19/2020
Appeals and Clerical Error Reopenings Module Open in New Window05/20/2020
Appeals Timeliness Calculator Open in New Window03/09/2020
Appeal Levels and Timely Filing Limits: Helpful Information 03/02/2020
Fully Favorable Decisions: Part A and Part B Appeals 02/10/2020
What is My Appeal Status? Module Open in New Window12/17/2019
Part A East Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration 08/29/2019
Adding Late Charges to A Claim 03/27/2019
Clarification of the First Level Appeal Decision Letter 03/27/2019
Appeals Status Tool Open in New Window03/25/2019
   

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Last Updated: 4/01/2021

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