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    Nov 28 12

    Medicare Won’t Pay Your Claim in Newport Beach? Appeal It!

    Newport Beach Law Firm

    processed 906 billion outpatient insurance claims in 2010 – and refused to pay
    10 percent of them. But if you're a senior on Medicare with a denied claim,
    your odds of turning that around are surprisingly good if you appeal.

    Elderly Woman with NurseFew things are more frustrating
    than battling bureaucracy. But if you’ve had a Medicare claim denied – and
    about 10 percent of Medicare claims are denied – you’re well-advised to hang in
    there and fight the good fight!

    Reuters recently published an article explaining “How to appeal when Medicare won't pay.” It is
    not an uncomplicated process, but if Medicare refuses to pay for services your
    doctor recommends it’s certainly worth your while to fight. The numbers are
    fairly enlightening:

    In 2010, 40 percent of
    Part A appeals and 53 percent of Part B appeals were granted, according to the
    Centers for Medicare & Medicaid Services, which administers Medicare (CMS).
    Even in the case of big ticket durable medical equipment appeals, 44 percent of
    appeals were successful. More than half of appeals to Medicare Advantage and
    prescription drug plans are successful, too.

    Medicare consumer advocates offer these tips for filing an appeal:

    1. Send a letter. Your paper trail starts with the summary
      notice of coverage you get in the mail. Take this notice, circle the erroneous
      denial, and write out why you think it should be covered. Make a copy, and mail
    2. Don’t waste time. You have 120 days to file an appeal
      for Medicare Part B claims, and only 60 days for Medicare Advantage or Part D.
      If you filed for pre-approval and were denied, you have only 14 days to
      initiate your appeal.
    3. Be persistent. You have a right to four levels of
      appeal, so don’t quit until you have exhausted all of your options.
    4. Get help. For appeals beyond the first level, you may
      want to seek help from an elder law attorney.

    Contact your Newport Beach
    estate planning attorneys at Meier Law Firm to discuss all of your estate planning

    Reference: Reuters
    (November 13, 2012) “How to appeal when Medicare won't pay

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