If you disagree with Medicare’s decision on how a pilot claim was processed, you may request an appeal. This is the only time the appeals process should be used.
Appeal: A request to review a claim when there is dissatisfaction with the original determination. An appeal is a review process and is an independent re-examination of an initial claim determination.
A claim must be appealed within 120 days from the date on the Medicare Pilot Program for Asbestos Related Disease Remittance Advice (RA). An appeal decision letter will be mailed to the provider or supplier who submitted the appeal.
Appeals Form [PDF]
Items Needed for an Appeal:
Mail or Fax Appeal:
Commonly Asked Questions:
Q. Who can submit an appeal?
Q. When should an appeal be submitted?
Q. How long does an appeal take to be processed?
Q. Is there more than one level of appeal for the Medicare Pilot Program for Asbestos Related Disease, similar to Fee-for-Service Medicare?
Q. How do I check the status of my appeal if it has been more than 60 days and I have not received a response?