Fill out the form CMS-20027 (available in “Downloads” below).There are 2 ways that a party can request a redetermination: The notice of initial determination is presumed to be received 5 calendar days after the date of the notice, unless there is evidence to the contrary.Ī redetermination must be requested in writing. ![]() ![]() 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. Requesting a RedeterminationĪn initial determination decision is communicated on the beneficiary's Medicare Summary Notice (MSN), and on the provider's, physician's and supplier's Remittance Advice (RA). A redetermination is a review of the claim by Medicare Administrative Contractor (MAC) personnel not involved in the initial claim determination. Any party to the initial claim determination that is dissatisfied with the decision may request a redetermination.
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