Appeal Forms

General

Redetermination - (First level)

Reconsideration - (Second level)

  • CMS 20033 - Medicare Reconsideration Request

Administrative Law Judge (ALJ) Hearing - (Third level)

Medicare Appeals Council Review (Departmental Appeals Board (DAB)) - (Fourth level)

Se ha producido un error al procesar la plantilla. 
Java method "com.liferay.portal.kernel.util.DateUtil_IW.parseDate(String, String, Locale)" threw an exception when invoked on com.liferay.portal.kernel.util.DateUtil_IW object "com.liferay.portal.kernel.util.DateUtil_IW@51848120"; see cause exception in the Java stack trace.

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FTL stack trace ("~" means nesting-related):
	- Failed at: #assign norModifieddateObj = dateUtil...  [in template "medicare-velocity-templates-theme_SERVLET_CONTEXT_/templates/freemarker/content/free-form-text.ftl" at line 11, column 5]
	- Reached through: #include "medicare-velocity-templates...  [in template "10155#10193#74691" at line 1, column 1]
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1<#include "medicare-velocity-templates-theme_SERVLET_CONTEXT_/templates/freemarker/content/free-form-text.ftl">