The fact that many seniors have to resign to the fate of paying for their Medicare when their claims are not settled in full, is rather disturbing.
Especially given the fact that there are ways by which they could get their Medicare claims approved in full.
APPEALS THAT WORK
Visit www.cms.hhs.gov/cmsforms/down loads/cms20027.pdf to understand the re-appeal process. Just so you know, you can re-appeal for your medical claim to be approved within 120 days of its rejection. All you have to do is visit this site and download a re-determination form.
For starters, you should download the Re-Determination form from the Medicare website, fill it out and send to it back to Medicare. When your claim is denied or approved for a lesser amount, you will also receive instructions on how you should go about re-appealing for the claim.
The first thing that you should be doing is speaking to your doctor and ask him or her to provide you with a letter, which states the importance of the Medicare claim.
Common reasons for denial of treatment
REASON FOR DENIAL: A lot of times, you will find that the treatment or prescription that you have received may not result in your health condition improving. The denial letter in such a scenario will have words like chronic, not improving and others. So, keep a close watch out for this statement.
Example: Not long before, a patient suffering from Lou Gehrigs disease, was denied a Medicare claim. The reason given to him was that the care provided to him was not good enough to help him lead a healthy life. The patient argued that with the help of the Medicare claim he could help appoint a nurse, which could be helpful in delaying the progress of the disease, if not help in curing it.
DONT GIVE UP
Your Medicare claim could be approved or rejected, but dont lose heart if it is rejected. You have the right to re-appeal for your Medicare claim four times, with the first one being heard by the same authority and all the other three by different arbiters. - 15437
Especially given the fact that there are ways by which they could get their Medicare claims approved in full.
APPEALS THAT WORK
Visit www.cms.hhs.gov/cmsforms/down loads/cms20027.pdf to understand the re-appeal process. Just so you know, you can re-appeal for your medical claim to be approved within 120 days of its rejection. All you have to do is visit this site and download a re-determination form.
For starters, you should download the Re-Determination form from the Medicare website, fill it out and send to it back to Medicare. When your claim is denied or approved for a lesser amount, you will also receive instructions on how you should go about re-appealing for the claim.
The first thing that you should be doing is speaking to your doctor and ask him or her to provide you with a letter, which states the importance of the Medicare claim.
Common reasons for denial of treatment
REASON FOR DENIAL: A lot of times, you will find that the treatment or prescription that you have received may not result in your health condition improving. The denial letter in such a scenario will have words like chronic, not improving and others. So, keep a close watch out for this statement.
Example: Not long before, a patient suffering from Lou Gehrigs disease, was denied a Medicare claim. The reason given to him was that the care provided to him was not good enough to help him lead a healthy life. The patient argued that with the help of the Medicare claim he could help appoint a nurse, which could be helpful in delaying the progress of the disease, if not help in curing it.
DONT GIVE UP
Your Medicare claim could be approved or rejected, but dont lose heart if it is rejected. You have the right to re-appeal for your Medicare claim four times, with the first one being heard by the same authority and all the other three by different arbiters. - 15437
About the Author:
For more insider details about medicare claims and what types of services are covered by reading the Humana Decision Guide at http://healthcaredecisionguide.com.
