The fact that many seniors have to resign to the fate of paying for their Medicare when their claims are not settled in full, is rather disturbing.
Many of them feel that they might have to pay in full or partially to cover for the claim, if it is rejected.
APPEALS THAT WORK
There are chances your Medicare claim could be denied or be settled at an amount far less than the claim amount. If this happens, you have the option of re-appealing for the claim within 120 days. All you have to do is request a re-determination of the decision.
For starters, you should download the Re-Determination form from the Medicare website, fill it out and send to it back to Medicare. When your claim is denied or approved for a lesser amount, you will also receive instructions on how you should go about re-appealing for the claim.
The first thing that you should be doing is speaking to your doctor and ask him or her to provide you with a letter, which states the importance of the Medicare claim.
Common reasons for denial of treatment
REASON FOR DENIAL: Often, you will find Medicare denying the claim because it feels that the care provided is not good enough to help the patient lead a healthy life. In these cases, you would find the occurrence of words like chronic, not improving, common.
Example: Not long before, a patient suffering from Lou Gehrigs disease, was denied a Medicare claim. The reason given to him was that the care provided to him was not good enough to help him lead a healthy life. The patient argued that with the help of the Medicare claim he could help appoint a nurse, which could be helpful in delaying the progress of the disease, if not help in curing it.
DONT GIVE UP
When you submit a claim for Medicare, you obviously start expecting that it should be approved. If it does get approved, youre a happy camper, but if it doesnt, you obviously have four chances to re-appeal. Apart from the first appeal, you will find all other appeals being held in front of independent arbiters.
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