Appeal Rights: Know the Rules

You may appeal claims that are partially or fully denied, as long as the claim has appeal rights. The appeal rights are outlined in your remittance notice and must be filed within 120 days of the date of the remittance notice. Important points to remember:

• The 120-day clock begins with the initial determination. If you filed multiple claims and received multiple denials, the time begins with the remittance notice for the first claim. (Claims that are "returned as unprocessable" with remark code MA130 do not have appeal rights and are not subject to the 120-day timeframe.)
• Please do not file duplicate appeal requests. Palmetto GBA processes most appeal requests within 60 days of receipt. Use the Palmetto GBA Redetermination Status tool to verify that your appeal request has been received.
• If you have already submitted an appeal request, please do not resubmit the claim. Filing a new claim does not protect your appeal rights.