More information on Appeals can be found in Chapter 8 (Reopenings and Appeals) of the DME MAC A Supplier Manual.
Appeals FAQs can be found within the NHIC, Corp. FAQ Database.
Faxed Reopenings
The Faxed Reopening process is described in the Fax Reopening Cover Sheet, which can be found
on the CMN and Forms page. Please do not use the fax
reopening fax line for any submissions other than Reopening requests.
Telephone Reopenings
Telephone Reopenings are described as claim reopenings that can be performed live over the telephone in order to correct clerical errors. The Telephone Reopening line is available Monday through Friday from 8:00am until 4:00pm EST at: 317-595-4371
Suppliers should have the following information available before contacting the telephone reopenings line:
- PTAN (NSC) Number
- Beneficiary’s Medicare Number
- Beneficiary’s Name
- Date of Service
- Claim Control Number
Redeterminations
Redetermination requests may be faxed to 781-741-3118.
The cover sheet for redetermination requests can be found on the CMN and Forms page.
You may also mail your Redetermination to the following addresses.
Please be sure to use the 9 digit zip code.
DME – Redeterminations
P.O. Box 9150
Hingham, MA 02043-9150 |
Redetermination Street Address for Overnight Mailings:
NHIC DME MAC Jurisdiction A
Appeals
75 William Terry Drive
Hingham, MA 02044 |
A redetermination request must be made within 120 days from the date of denial on the Medicare Remittance Advice (RA) otherwise it will be denied as untimely. For assistance in calculating this date visit the Self-Service Tools section of our web site and click on the Redetermination Request Calculator.
Reconsiderations
Requests for reconsideration must be filed to the following QIC contractor:
RiverTrust Solutions, Inc.
1 Cameron Hill Circle Ste 0011
Chattanooga, TN 37402-0011 |
For Overnight Deliveries:
RiverTrust Solutions, Inc.
1 Cameron Hill Circle
Chattanooga, TN 37402 |
Administrative Law Judge (ALJ) Hearings Mailing Address
HHS OMHA Mid-West Field Office
BP Tower, Suite 1300
200 Public Square
Cleveland, OH 44114-2316
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