RSS

Introduction Checklist for Ambulance Appeals Quick Screen – Should My Ambulance Transport Be Covered By Medicare? Ambulance Transport Appeal Details Additional Information Glossary of Terms Medicare Regulations for Coverage of Ambulance Transportation Medicare Regulations Regarding Appeals Centers for Medicare & Medicaid Services Manual Provisions (CMS) Manual Provisions 1. Introduction Dear Medicare Beneficiary: The Center for … Read more

Introduction How to Use This Packet Observation Status Self-Help Federal Regulations – Requirements for Medicare Coverage for Skilled Nursing Facility Care Pertinent Federal Regulations for Medicare Appeals INTRODUCTION Dear Medicare Patient: The Center for Medicare Advocacy has produced this Self-Help Packet to help you understand Observation Status and options for beneficiaries who are placed on … Read more

Introduction Checklist for Outpatient Therapy Discharges Checklist for Outpatient Therapy Appeals Quick Screen: Medicare Coverage for Outpatient Therapy Outpatient Therapy Appeal Details   Additional Information 1. Introduction Dear Medicare Patient: The Center for Medicare Advocacy has produced this packet to help you understand Medicare coverage and how to file an appeal if appropriate. Medicare is the … Read more

Introduction Checklist for Home Health Appeals Quick Screen: Should My Home Health Care Be Covered By Medicare? Home Health Appeal Details Additional Information The “Improvement Standard” Myth and Home Health Care Glossary of Terms Federal Regulations – Home Health Coverage Federal Regulations – Expedited Appeals Centers for Medicare & Medicaid Services (CMS) Home Health Manual Provisions … Read more

Introduction Hospital Discharge Checklist Hospital Coverage Quick Screen Hospital Discharge Rights & Action Steps Glossary of Terms Federal Regulations Introduction The Center for Medicare Advocacy produced this packet to help you understand Medicare coverage and how to file an appeal if appropriate.  Medicare is the national health insurance program to which many people with disabilities … Read more

Introduction Checklist for Skilled Nursing Facility (SNF) Appeals Quick Screen: Should My SNF Care Be Covered By Medicare? Skilled Nursing Facility Appeal Details Additional Information The “Improvement Standard” Myth and Skilled Nursing Facility Care Glossary of Terms Federal Regulations – SNF Coverage Federal Regulations – Expedited Appeals Centers for Medicare & Medicaid Services (CMS) Manual Provisions 1. Introduction … Read more

1. First Steps      Review the Center for Medicare Advocacy’s Self-help Packets and coverage guidelines regarding the particular level of care involved in the appeal at: http://www.medicareadvocacy.org.   Watch for, receive and review the Medicare Reconsideration decision.  If the decision denies Medicare coverage, you only have 60 days to appeal from the date of … Read more

Here’s the Issue  Expedited Medicare appeals and standard Medicare appeals are designed to address different things and there are situations where a Medicare beneficiary must pursue both types of appeals. Expedited Appeals – Address whether the provider’s termination of Medicare-covered services was proper. Standard Appeals – Address whether any subsequent services the beneficiary chose to … Read more

If you are eligible for Medicare you can chose between getting your Medicare benefits through traditional Medicare (also commonly referred to as original Medicare) or a Medicare Advantage (MA) plan.  Making this choice is personal and requires that you consider your circumstances, including your health, your desire for flexibility, your budget and your tolerance for … Read more