Medical Billing Forum

General Category => General Questions => Topic started by: pvtbiller on November 05, 2012, 04:44:27 PM

Title: Missed the deadline for a Redetermination
Post by: pvtbiller on November 05, 2012, 04:44:27 PM
PLEASE HELP!  I am cleaning up a bit of a mes here.  There are about 50 claims that the timely filing limit on submitting a Redetermination Appeal to Medicare were missed.  I know that the "good cause" for a provider are super slim but the fact is that we have a larger case that I was prepping for an ALJ on and I just couldn't get it all done.  I really though the ALJ would come quicker than it is and we wouldn't have to take all these appeas\ls forward and the ALJ would overturn the denials?  What can I do?  Am I totally out of luck?
Title: Re: Missed the deadline for a Redetermination
Post by: Michele on November 07, 2012, 06:59:13 AM
I don't mean to be stupid and it's been a rough week, but what's a ALJ?
Title: Re: Missed the deadline for a Redetermination
Post by: pvtbiller on November 07, 2012, 08:07:23 AM
Hi Michele,

No worries, an ALJ is an Administrative Law Judge Hearing after a reconsideration appeal was denied.  It  is the third level of an appeal
Title: Re: Missed the deadline for a Redetermination
Post by: Michele on November 13, 2012, 09:09:56 AM
Oh, sorry.  Been a rough couple weeks.  I believe if you missed the deadline to get it to the ALJ there isn't much you can do.  If you have it all ready it's worth the shot of sending it in, but I think they are pretty strict.  :(