CatchTheWind
Guest
Medicare states "If a Medicare Advantage (Part C) health plan makes an adverse reconsideration decision (upholds its initial adverse organization determination), the plan must automatically submit the case file and its decision for review by the Part C Independent Review Entity (IRE)."
We have often gotten letters from Medicare Advantage plans upholding their denials after we appealed, and never have we had any indication that they have submitted a copy of their decision to the IRE.
Why isn't this happening? And if they aren't doing it, can we contact the IRE ourselves?
We have often gotten letters from Medicare Advantage plans upholding their denials after we appealed, and never have we had any indication that they have submitted a copy of their decision to the IRE.
Why isn't this happening? And if they aren't doing it, can we contact the IRE ourselves?