Home Health & Hospice Week

Don’t let a first-level appeal time out due to missing technicalities.

If certain information in your appeal is “missing, incorrect or incomplete, your redetermination request will be dismissed,” the Centers for Medicare & Medicaid Services warns. “You may resubmit a completed redetermination; however it must be submitted within 120 days from the date of receipt of the notice of initial determination.”

Your redetermination request must include: the beneficiary full name; beneficiary’s Medicare ID number; specific services(s) and/or item(s) for which the redetermination is being requested; specific date(s) of service (To and From); printed name of requestor; and signature of the requestor, CMS instructs.

See more info in the revised chapter 29 of the Medicare Claims Processing Manual at www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c29.pdf.