Practice Management Alert

Alert:

Medicare Shortens the Appeals Process

Heads up, medical office billers: The window of time you have to file Medicare appeals just got 60 days shorter.

Effective Oct. 1, 2002, the filing deadline for requesting Medicare claims appeals is now 120 days for both Part A and Part B claims. This deadline decreases Part B's period by 60 days. The change comes from a provision in the 2002 Benefits Improvement and Protection Act (BIPA), which eliminated the distinction between Part A and Part B claims review by setting the 120-day limit for both.

As of Oct. 1, carriers will have already implemented an interim process for managing beneficiary appeal requests under the BIPA guidelines. You should file accordingly:

  • If the initial determination is dated December 31, 2002, or earlier, you have six months to file Part B appeal requests.
  • If the initial determination is dated January 1, 2003, or later, you have only 120 days to file Part B appeal requests. $ $ $