Step by Step

1. Get the Medicare Summary Notice that shows the item or service you are appealing. Your MSN is the statement you get every 3 months that lists all the services billed to Medicare and tells you if Medicare paid for the services.

2. Circle the item(s) you disagree with on the MSN, and write an explanation on the MSN of why you disagree.

3. Sign, write your telephone number, and provide your Medicare number on the MSN, Keep a copy for your records.

4. Send the MSN, or a copy, to the Medicare contractors’s address listed on the MSN.  You can also send any additional information you may have about your appeal.

5. You must file the appeal within 120 days of the date you get the MSN. If you want to file an appeal , make sure you read your MSN carefully, and follow the instructions.  You can also use CMS Form 20027 and file it with the Medicare contractor at the address listed on your MSN.

I have attached the link for your convenience.

www.cms.hhs.gov/cmsforms/downloads/CMS20027.pdf

For more inquires on other plans and appeal processes, Email me at questions@caramedic.com

Andrew Caramico

CARAmedic Solutions