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I disagree with a claims decision; how do I request an appeal?

I disagree with a claims decision; how do I request an appeal?

Appeals information is included on each Medicare Summary Notice (MSN). If you disagree with any claims decision on the notice, you can request an appeal.To request an appeal:1. Circle the item(s) you disagree with and explain why you disagree.2. Sign and provide your telephone number.3. Send the notice, or a copy, to the address in the "Customer Service Information" box on page 1 of the MSN.The time limitfor filingan initialPart A or Part BAppeal is 120 Days from the date of notification regarding Medicare's denial or paymentonyour claim.You must request an appeal within 120 days (about 4 months) of the date of Medicare's notice of denial or payment on your claim.Additional information about the appeal process and downloadable appeal forms can be found in the Medicare Claims, Appeals Information, and Medicare Summary Noticessection of www.medicare.gov.

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Medicare Appeals
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