Available via an annual subscription, our 32 fact sheets cover 9 different Medicare and other health insurance topics. Those fact sheets pertaining to Medicare Appeals include:
- Appeals: When Your Part A or B Medicare Claim is Denied (A-006)
- Medicare Advantage: If You Have Problems With Your Medicare Advantage Plan (C-002)
- When Your Part D Prescription is Denied (D-003)
Websites & Other Resources
- Medicare Beneficiary Complaint Chart (PDF) – March 2009
- Lists phone numbers, websites and resources for help in reporting complaints. Complaints include those with physicians, hospitals, home health care, skilled nursing care, durable medical equipment, pharmacists, Medicare fraud and insurance agents.
- California’s Quality Improvement Organization (QIO), which provides:
California Medicare Appeals Helpline: 1-877-588-1123 Helps beneficiaries appeal discharge from a hospital, skilled nursing facility, home health agency or comprehensive outpatient rehabilitation facility. Also files complaints regarding quality of Medicare-covered services
- First Coast Service Options (FCSO)
- California’s Qualified Independent Contractor (QIC) for Part A and B appeals, which performs reconsideration reviews (Level 2 in the Medicare Part A and B appeals process).
- Health Insurance Counseling & Advocacy Program (HICAP)
- 1-800-434-0222 Free counseling about Medicare, Medigap policies, Medicare Advantage plans, filing an appeal and long-term care insurance.
- MAXIMUS Federal Services
- Serves as an Independent Review Entity (IRE) for:
• Medicare Part C (Medicare Advantage) appeals: medicareappeals.com
• Medicare Part D (Prescription Drug Coverage) appeals: medicarepartdappeals.com