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Claims and Dispute Resolution

Browse all the Lawforwa Resources on Claims and Dispute Resolution

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Medicare Appeals and Grievances
http://www.medicare.gov/publications/pubs/nonpdf/a
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services

Explains the appeal rights of Medicare beneficiaries under both the Original Medicare Plan and Medicare Managed Care Plans. Describes how to appeal such actions as failure to pay for an item or service or failing to provide an item or service the patient thinks should be covered or provided.
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Medicare Appeals Forms
http://www.medicare.gov/basics/forms/default.asp
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services

Links to online forms people can use in Medicare-related appeals. Forms include: Appointment of Representative, Request for Review of Part B Medicare Claim, Request for Hearing - Part B Medicare Claim, Request for Reconsideration of Part A Health Insurance Benefits, Request for Part A Medicare Hearing by an Administrative Law Judge, and Request for Part B Medicare Hearing by an Administrative Law Judge. Some forms are available in Spanish. Special tools are also provided to permit access to the forms by persons with visual disabilities.
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