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Printed Date: 9/22/2015
You can submit an Appeal online through our eServices tool. If you have an EDI Agreement on file with Medicare, you can register for eServices. If you are already a registered user in eServices you can immediately begin submitting Appeals through our Secure Forms section of the tool.
The Secure Forms section is on the Messaging/Forms tab. This is on the menu once you successfully log in. You should see the Secure Forms button to access available forms. Answer the questions on the page, and the forms available will appear as links at the bottom of the page.
Once you select the option to submit a Secure Form, a pre-populated form will appear with the information we have on file from your registration record. This will save you several steps. Then fill in all the information that is required for an appeal request (they are highlighted with red "asterisks"). Be sure to add attachments to support your appeal request. You may attach an unlimited number of PDF attachments to each form. Each attachment can be up to 40 MB in size. The total size of all attachments on each ADR form can be no more than 150 MB.
Your attachments can include, but are not limited to:
If you have any difficulties in uploading attachments or submitting the form, view our FAQ "How do I upload attachments to an Appeal request" for more information.
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Last Updated: 06/02/2020