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Re: [IP] Medicare ALJ case



There are 3 steps:
1. The supplier files for payment with the payor for Medicare (in Florida it 
is CIGNA)

2. If all or any part of the payment is denied you and the supplier get a 
letter to that issue and it tells you what you can do; appeal (called a 
Redetermination) to xxxxx

3. If your appeal (Redetermination)and/or the supplier receive a denial it 
will then tell you that you can file a Reconsideration.

4. if this is filed and results in a denial; next comes the appeal to the 
ALJ.

My supplier has just done this.
All of this is not only time consuming and irritating, but, involves 
documentation. I am so very fortunate that Advanced Diabetes Supply has gone 
the full course for me. Now we wait for the ALJ hearing.

As related to my part in filing; waiting to hear about the Reconsideration 
that was filed for me by my Senator.
Phyllis


----- Original Message ----- 
From: "Beverly P White" <email @ redacted>
To: <email @ redacted>
Sent: Friday, July 01, 2011 10:12 AM
Subject: Re: [IP] Medicare ALJ case


> Sorry I am hoping in the middle here....reconsideration of what? Medicare
> paying for supplies?Bev, mom to Mary, almost 18, dx 1997, pumping 01 and 
> looking
> at Medicare for disability 
.
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