Filing Appeals

I hope all of you are staying safe and surviving this long winter. But the good news is that spring is right around the corner and we should be getting some warmer days. I also hope all of you are working through the vaccine maze and getting your COVID vaccinations. Once most of us are vaccinated, we may be able to get back to some form of normalcy in our lives. Between spring approaching and the vaccines, there is much to look forward to in the coming weeks.

One of the issues that we hear often from our clients is concerns over denied services. Sometimes, a medical service or a prescription drug gets denied by the plan and we do not know why it is denied, or we do not agree with the denial. In Medicare, plans must offer an appeal process so that a beneficiary can appeal a denial of a service or medication. Attached for your information is a general overview of the Medicare appeal process for Medicare Advantage plans. Keep in mind that most plans will allow an appeal to be done over the telephone so the process has evolved and is a little easier.

We hope you find this information useful and as always, if you have any issues or questions, please feel free to contact us at 717-980-3201 or at info@mediplanconnect.com.

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