NEW Self Help Packets for Expedited Appeals
- Self-Help Packet for Outpatient Therapy Denials Including “Improvement Standard” Denials April 1, 2014
- Self Help Packet for Expedited Home Health Care Appeals Including “Improvement Standard” Denials February 22, 2013
- Self Help Packet for Expedited Skilled Nursing Facility Appeals Including “Improvement Standard” Denials February 12, 2013
- Self Help Packet for Medicare “Observation Status” February 12, 2013
Older .PDF versions – not updated::
- Self Help Packet for Outpatient Physical Therapy Denials (.pdf)
- Self Help Packet for Home Health Denials (.pdf)
- Self Help Packet for SNF Denials (.pdf)
Our Self-Help Packets Work:
"I went to [the Center for Medicare Advocacy's] website and downloaded the Improvement Standard Self-help Packet and discussed it with the family. I was amazed at what happened next. When we spoke with the social worker, she admitted, "I don't know the Medicare regulations, I've never read them." The family was able to stand up for their mother's Medicare benefits by outlining, point by point from the self-help packet, the reasons why she met the skilled nursing care coverage criteria. The social worker quickly backed down from insisting that mother be moved out of the rehab bed within the next few days. She agreed to delay the decision to move the patient until after the follow-up appointment with the doctor a week later.
At the hospital, the family was able to effectively communicate with the doctor, and his orders did not change (no weight, PT & OT 4x per day). To everyone's relief, the patient is still in the rehab bed. The extra 70 days in rehab will be covered by Medicare and the co-pay will covered by their supplement…this is a tremendous saving for this family."
Executive Director, ApparentPlan
Public Policy Director, Minnesota Board on Aging