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Fill out a Redetermination Request Form [PDF, 100 KB] and send it to the company that handles claims for Medicare. Their address is listed in the Appeals Information section of the MSN. Or, send a written request to company that handles claims for Medicare to the address on the MSN.
DME MAC Jurisdiction B - DME Facts JB processes FFS Medicare DME claims for Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.
A/B MAC Jurisdiction M (formerly known as Jurisdiction 11) Part A and Part B Facts. JM processes FFS Medicare Part A and Part B claims for North Carolina, South Carolina, Virginia, and West Virginia.
DME MAC Contractor Codes (Payer IDs): Jurisdiction B: 17013. Jurisdiction C: 18003.
State Specific Exceptions CorrespondenceUSPSExtended Repayment ScheduleNoridian Medicare JE Part B Refund ATTN: Extended Repayment Schedule PO Box 511381 Los Angeles, CA 90051-7914Fraud and Abuse / Benefit ProtectionNoridian JE Part B Attn: Fraud and Abuse/Benefit Protection PO Box 6710 Fargo ND 58108-671011 more rows

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Submit a written request that includes: Your name and Medicare Number. The specific item(s) and/or service(s) youre requesting a reconsideration for and the specific date(s) of service. You can find this information in your Medicare Redetermination Notice.
DME MAC Jurisdiction B - DME Facts JB processes FFS Medicare DME claims for Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. Archives: DME MAC Jurisdiction B - CMS cms.gov medicare-contracting archive-jb cms.gov medicare-contracting archive-jb
Jurisdiction A is serviced by Noridian Healthcare Solutions and includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.
DME MAC Jurisdiction D DME Facts JD processes FFS Medicare DME claims for Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming. Archives: DME MAC Jurisdiction D - CMS cms.gov medicare-contracting archive-jd cms.gov medicare-contracting archive-jd
A/B MAC Jurisdiction H (formerly known as Jurisdiction 4 and 7) Part A and Part B Facts. JH processes FFS Medicare Part A and Part B claims for Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas.

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