Medicare Appeals Process Brochure Revised

CMS has revised “The Medicare Appeals Process: Five Levels to Protect Providers, Physicians and other Suppliers” brochure for 2011. This brochure provides an overview of the Medicare Part A and Part B administrative appeals process available to providers, physicians, and other suppliers who provide services and supplies to Medicare beneficiaries. Changes for 2011 include the following: • When requesting a redetermination, contractors can no longer correct minor errors and omissions on claims through the appeals process. • The amount in controversy threshold for a third-level appeal administrative law judge hearing is $130. • The amount in controversy threshold for a fifth-level appeal judicial review in U.S. district court is $1,300.