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Printed Date: 9/22/2015
An analysis of appeal receipts has shown a significant increase in the number of duplicate appeal requests being received for the same patient and the same service. This increases the number of appeals that must be worked, which in turn increases the time it takes Palmetto GBA to complete the appeal.
As your Specialty Medicare Administrative Contractor (RRB SMAC), Palmetto GBA has 60 days to complete a redetermination decision. If you are not sure if your request has been received, please use the redetermination status tool on the Railroad Medicare website to check the status of your appeal. The status tool is located under ‘Self Service Tools’ and will let you know if your request is being processed.
The following bullets include examples of situations that result in duplicate appeal requests:
In some cases, redetermination requests are submitted, and within one to five days after the first submission a second request is submitted with one or two additional pages that were not included with the original submission. To ensure that the additional information is matched with your initial request, please consider the following:
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Last Updated: 02/08/2018