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Appeals - JD DME

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Billing, Claims, and Appeals

  • Appeals
  • Billing Situations
  • Claim Submission
  • Electronic Claim Submission
  • Healthcare Integrated General Ledger Accounting System (HIGLAS)
  • Medicare Secondary Payer (MSP)
  • Overpayments and Recoupment
  • Reopening

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Appeals

Access the below appeal level related information from this page.

  • Redetermination - First Level
  • Reconsideration - Second Level
  • Administrative Law Judge (ALJ) Hearing - Third Level
  • Medicare Appeals Council Review - Fourth Level
  • Federal Court Review - Fifth Level

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Resources

  • CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 29 - Appeals of Claims Decisions
  • CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 34 - Reopening and Revision of Claim Determinations and Decisions
  • Medicare Claims Appeal Procedures; Final Rule

 

Last Updated Fri, 05 Mar 2021 21:12:13 +0000

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