May 31, 2018 - Updated: 07.08.19
Avoid Redetermination Dismissals
When submitting a request for a redetermination, which is the first level of appeal, the request must include the following information.
- Beneficiary full name;
- Beneficiary’s Medicare identification number;
- Specific services(s) and/or item(s) for which the redetermination is being requested;
- Specific date(s) of service (To and From);
- Printed name of requestor.
If the above information is missing, incorrect or incomplete, your redetermination request will be dismissed. You may resubmit a completed redetermination; however it must be submitted within 120 days from the date of receipt of the notice of initial determination. Please refer to the CMS Medicare Publication 100-04, Chapter 29, Section 310.6 for additional information.