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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.
A. A reconsideration involves a thorough, independent review of all evidence from the initial determination and any new evidence the claimant or another individual submits in connection with the request for reconsideration.
A reconsideration is an independent review of the administrative record, including the initial determination and redetermination, by a Qualified Independent Contractor (QIC).
How long your plan has to respond to your request depends on the type of request: Expedited (fast) request\u201472 hours. Standard service request\u201430 days.
Appeal the claims decision. 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.
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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. At the first level of the appeal process, the MAC processes the redetermination.
Appeals Level 2: Qualified Independent Contractor (QIC) Reconsideration | Medicare. Here's how you know. Official websites use .gov. A .gov website belongs to an official government organization in the United States.
Appeals Level 3: Decision by the Office of Medicare Hearings and Appeals (OMHA) You may request a decision by OMHA, based on a hearing before an Administrative Law Judge (ALJ) or, in certain circumstances, a review of the appeal record by an ALJ or attorney adjudicator.
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.
Expedited (fast) request\u201472 hours. Standard service request\u201430 calendar days. Payment request\u201460 calendar days.

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