The Medicare Appeals Process becomes more involved with each step. The amount of days allowed to file an appeal and request the claim be reviewed at the next level becomes shorter. Documentation and lengthy forms to fill out can be extremely time consuming. With each level of appeal witnesses will be called upon for professional input, the patient will also be called upon for a telephone interview and if the appeal continues in may end up in US District court.Medicare along with other insurance carriers have set guidelines of what are allowable procedures, equipment, etc. Some examples of reason a claim is denied would be: The provider thinks the recommended treatment is medically necessary. Medicare denies the claim because they want more
