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Medicare Advantage: Claims: Appeals

The Appeals Process

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The appeals process will be spelled out in the denial letter. It will also include dates by which appeals must be started. Do not assume you can appeal after the described date.

After the internal review process, you have the right to have a denial of reviewed by an independent body that contracts with Medicare.

If you do not receive satisfaction, you have the right to appeal to an Administrative Law Judge, and eventually to use the courts.

If you have difficulty that may be newsworthy, see: How To Involve The Press.


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