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Second Level of Appeal: Reconsideration by a Qualified Independent Contractor. Any party to the redetermination that is dissatisfied with the decision may request a reconsideration.
Second Level of Appeal: Reconsideration by a Qualified Independent Contractor. Any party to the redetermination that is dissatisfied with the decision may request a reconsideration.
The Social Security Act (the Act) establishes five levels to the Medicare appeals process: redetermination, reconsideration, Administrative Law Judge hearing, Medicare Appeals Council review, and judicial review in U.S. District Court.
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DAB E-File is accessible at . Registration. A party or a partys representative must become a registered user of DAB E-File. If a party has more than one representative, each representative must register separately to use DAB E-File on the partys behalf.
The first level of an appeal for Original Medicare is called a redetermination. A redetermination is performed by the same contractor that processed your Medicare claim. However, the individual that performs the appeal is not the same individual that processed your claim.
The 5 Levels of the Appeals Process Redetermination. Reconsideration. Administrative Law Judge (ALJ) Departmental Appeals Board (DAB) Review. Federal Court (Judicial) Review.
The 5 Levels of the Appeals Process.
First Level of Appeal: Redetermination by a Medicare Administrative Contractor (MAC) Second Level of Appeal: Reconsideration by a Qualified Independent Contractor (QIC) Third Level of Appeal: Decision by the Office of Medicare Hearings and Appeals (OMHA) Fourth Level of Appeal: Review by the Medicare Appeals Council.

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