What it is
This CMS publication explains how to appeal a Medicare coverage or payment decision, from the first-level redetermination through Administrative Law Judge review and beyond. It includes timelines, forms, and where to file at each level.
Who should read this
- Anyone whose claim was denied.
- Beneficiaries facing a hospital-discharge decision they disagree with.
- Caregivers appealing on behalf of a family member.
Key topics covered
Five levels of appealTimelines and deadlinesExpedited appealsWhere to file