tci Medicare Compliance & Reimbursement - 2006 Issue 29

APPEALS: Learn How To Fight Billing Revocations All The Way To Court

You can appeal enrollment denials to an ALJ.Be prepared for some changes to the appeals system soon. If your contractor revokes your billing privileges or denies you enrollment in Medicare, you can appeal that decision to an administrative law judge (ALJ) within the U.S. Department of Health and Human Services, according to July 14 Transmittal 151. After an ALJ hearing, you may also be entitled to review by the Department Appeals Board (DAB) and a judicial hearing, according to the Centers for Medicare & Medicaid Services (CMS).You'd have 60 days to request a reconsideration of...

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