Appeals Decision Correspondence - JD DME
Appeals Decision Correspondence
Decision | Type of Correspondence |
---|---|
Full Reversal (Fully Favorable) | A new Remittance Advice (RA) and payment will be issued |
Partial Reversal (Partially Favorable) | A new RA is sent and a letter mailed to appellant or representative detailing the decision and further appeal rights. All parties to appeal are copied on the decision. An adjustment is also performed with additional monies issued |
Affirmation (Unfavorable) | A letter is sent to appellant or representative detailing decision and further appeal rights. All parties to appeal are copied on the decision. No additional coverage can be allowed |