Being More Appealing. Bobbi Buell ION October, 2008. AGENDA. Medicare Appeals Process The Appeal Cycle Assessment/ Analysis Information Gathering Appeal Drafting Follow Up Tools for Providers. PART A & PART B PROCESS (Non-Expedited). Beneficiary receives the service
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Being More Appealing
“reconsideration” by Qualified Independent
For ALJ hearings under Parts A, B, C & D
A statement by the pharmacy (not by the Plan) that the Plan will not cover a requested drug is not a coverage determination
If a coverage determination is unfavorable:
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