tci Medicare Compliance & Reimbursement - 2020 Issue Q4

Medicare Appeals Quiz: Test Your Appeals Know-How With 5 Tough Questions

Tip: Timelines vary by appeal level. Whether you’re a Medicare claims novice or master, appealing a denied claim can be daunting. With complicated steps and requirements, it’s easy to mess up and have to start the process all over again. Reminder: There are five levels of the Medicare appeals process. They include: Level 1: Redetermination, which goes through your Medicare Administrative Contractor (MAC). Level 2: Reconsideration, which goes through the qualified independent contractor (QIC). Level 3: Administrative Law Judge (ALJ) Hearing. Level 4: Medicare Appeals Council Department Appeals Board (DAB). Level 5: U.S. Federal District Court...

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