How do I submit an Appeal online?

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:

  • Supporting documentation
    • Orders
    • Invoices
    • Progress notes
    • Operative reports
    • Run/trip sheets for ambulance transports
  • Signed transfer of appeal rights form  
  • Appointment of representative form 

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.

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC


National Supplier Clearinghouse MAC


RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries



Click to Chat Now