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Medicare beneficiaries have the right to appeal an adverse determination, called a denial of coverage. After an initial coverage determination has been made, if the beneficiary is dissatisfied, then he or she may request reconsideration. Following reconsideration, if the beneficiary remains dissatisfied, then he or she may request a hearing before an administrative law judge. If the beneficiary is dissatisfied with that decision, then he or she may request a hearing before the Medicare Appeals Council. Thereafter, the beneficiary may appeal the decision to federal district court.
The links below include information regarding the appeal process. If you would like to speak with an attorney about your appeal rights, you may contact the Elder Law Practice at 706-428-0888.
Office of Medicare Hearings and Appeals
Understanding the Appeals Process
Appeals Process by Medicare Type
CMS - Standard Appeals Process
CMS - Medicare Appeals Process
CMS Form - Appointment of Representative
Medicare Rights Center - 1-888-HMO-9050
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