You must complete the Medicare Redetermination Request form if you’re appealing a claim denial by Medicare for the first time. This leads to the first phase of the Medicare appeals process. If you’re ...

If your claim is denied, first talk with the doctor (or hospital) and Medicare to see if you can identify the problem and get the claim resubmitted. “When Medicare rejects a bill, it’s often because ...

If you have Original Medicare and disagree with a coverage or payment decision, or the amount of a claim that’s been paid, you can complete and return a Medicare appeal form. When a doctor, healthcare ...

The rate of Medicare Advantage (MA) claims has escalated in recent years, prompting medical and government scrutiny of prior authorization processes that slow down care in favor of cost savings.

A person may appeal any Medicare decision to deny coverage. For a better chance of winning an appeal, they should gather and include supporting information from a doctor or healthcare professional.

Dear Toni: I have a $2,000 doctor bill with a new cardiologist, and Medicare says it will not pay. I recently retired and enrolled in Medicare and a Medicare supplement for the freedom to pick my own ...

AudioEducator will host a live audio conference on Medicare Appeal Process: Collect What Your Practice Really Deserves! This conference will be presented by renowned speaker Barbara J. Cobuzzi on ...

Dear Savvy Senior: How does one go about appealing Medicare when they won’t pay for something that has been covered in the past? — Denied Senior Dear Denied: If you disagree with a coverage or payment ...

Retirees are paying slightly higher premiums for Medicare Part B in 2025, with an increase of almost 6% from 2024. The premium rose to $185 in 2025, up $10.30 from $174.70 in 2024. Price hikes ...

On March 15, 2020, Alex Azar, Secretary of the Department of Health and Human Services (“HHS”) issued Waiver or Modification of Requirements Under Section 1135 of the Social Security Act, available ...