Medicare Claims Processing Manual - Centers for Medicare ...

Medicare Claims Processing Manual Chapter 29 - Appeals of Claims Decisions Table of Contents (Rev. 4380, 08-30-19). Transmittals for Chapter 29. 110 - Glossary 200 - CMS Decisions Subject to the Administrative Appeals Process 210 - Who May appeal - Provider or Supplier Appeals When the Beneficiary is Deceased 220 - Steps in the Appeals Process: Overview 230 - Where to appeal 240 - Time Limits for Filing Appeals & Good Cause for Extension of the Time Limit for Filing Appeals - Good Cause - Conditions and Examples That May Establish Good Cause for Late Filing by Beneficiaries - Conditions and Examples That May Establish Good Cause for Late Filing by Providers, Physicians or Other Suppliers - Good Cause Administrative Relief Following a Disaster - Procedures to Follow When a Party Fails to Establish Good Cause 250 - Amount in Controversy (AIC) Requirements - Amount in Controversy General Requirements - Principles for Determining Amount in Controversy - Aggregation of Claims to Meet the Amount in Controversy 260 - Parties to an appeal 270 - Appointment of Representative - Appointment of Representative - Introduction - Who May be an Appointed or Authorized Representative - How to Make and Revoke an Appointment - When and Where to Submit the Appointment - rights and Responsibilities of a Representative - Duration of Appointment - Curing a Defective Appointment of Representative - Incapacitation or Death of Beneficiary - Dis

Assignment of appeal rights – The transfer by a beneficiary of his or her right to appeal under the claims appeal process to a provider or supplier who is not already a party, and who provided the items or services to the beneficiary.

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