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Medicare Appeals

  1. #1
    Default Medicare Appeals
    Medical Coding Books
    I know this isn't quite the right place for this, but this group seems to be so helpful I thought it was worth asking.

    Does anyone know a good source for locating sample appeal letters to be submitted to Medicare?

    Thanks in advance for any assistance.

    Sue

  2. #2
    Default
    visit cahaba website if part b click on part b provider look for redetermination cms 20027 form.

  3. #3
    Default
    Thanks, mjones. We have the appeal forms, but due to the nature of the situation we need to submit a compelling letter of explanation to accompany the forms.

  4. #4
    Default
    Hi Sue:

    ACEP offers templated letters for appealing denied claims:

    http://www.acep.org/content.aspx?id=...l=1&collid=216

  5. #5
    Location
    Grand Rapids, MI
    Posts
    230
    Default
    I love appealletters.com

  6. Default Appeal Letters
    Hello,

    Does anyone have a sample appeal letter to submit to medicare or one that I can use for all appeals?

    Roseann

  7. #7
    Location
    Milwaukee WI
    Posts
    4,466
    Default Sample letter
    The simpler, the better.

    MEDICARE OFFICE ADDRESS

    Re: patient / subscriber # / DOBirth

    Dear Sirs,
    We are appealing denial of the following service, which has been erroneously denied as (reason for denial):
    DOS / CPT code / Description

    (Paragraph explaining circumstances ... cite CPT and/or CCI edits as appropriate)

    I enclose copies of the medical record. Please reconsider payment for this medically necessary service.

    If you have any questions, please do not hesitate to contact me at (phone #)

    Sincerely,
    Name, CPC
    Title


    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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