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Youll generally get a decision from the MAC (either in a letter or an MSN) called a Medicare Redetermination Notice within 60 days after they get your request. If you disagree with this decision, you have 180 days after you get the notice to request a reconsideration by a Qualified Independent Contractor (QIC).
Medicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided. If a claim isnt filed within this time limit, Medicare cant pay its share.
You can request an appeal within 120 days from the date you received the Medicare Summary Notice. Visit the Claims and Appeals section of Medicare.gov.
If your redetermination is unfavorable, you will receive an MRN which explains the rationale that was used in upholding the original claim determination.
Requesting a Redetermination The appellant (the individual filing the appeal) has 120 days from the date of receipt of the initial claim determination to file a redetermination request.

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If you do not file a petition for redetermination within 30 days after a Notice of Determination is mailed to you, the liability assessed in the Notice of Determination will become final.
Any party to the redetermination that is dissatisfied with the decision may request a reconsideration. A reconsideration is an independent review of the administrative record, including the initial determination and redetermination, by a Qualified Independent Contractor (QIC).
A claimant always has at least 6 calendar months after the month of correction in which to file. Correction of the error less than 6 full calendar months before expiration of the usual time limit will warrant an extension of time for the remainder of the 6 months.

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