Home Health & Hospice Week

Keep your timelines straight when it comes to Medicare claims appeals, so you don’t miss out on an opportunity to obtain your rightful reimbursement.

“You have 120 days from the date of the original Medicare remittance advice to submit an appeal” — a redetermination or first-level appeal, says HHH Medicare Administrative Contractor National Government Services in a new Frequently Asked Question set.

Pointer: “Multiple resubmissions of a claim will not extend the 120-day time limit,” NGS stresses. “The time limit begins with the original denied/processed claim.”

For second-level appeals, known as reconsiderations, you have a bit longer timeframe — 180 days from receiving your notice of the redetermination decision. You must file your reconsideration request with the Qualified Independent Contractor, NGS instructs in the FAQs.

An alternative: If your denial is due to “minor errors or omissions,” you can file a reopening, NGS reminds providers in the FAQs.