Medicare appeal for home health billing

General Medicare appeal rights
After Medicare makes a decision on a claim, you have the right to a fair, efficient, and timely process for appealing health care payment decisions or initial determinations on items or services you got.
You may appeal if either of the following is true:

A service or item you got isn’t covered, and you think it should be.

A service or item is denied, and you think it should be paid.

The company that handles claims for Medicare will send you a list of your claims, called The Medicare Summary Notice (MSN), every 3 months. This notice tells you if your claim is approved or denied. If the claim is denied, the reason for the denial will be included on the notice. The notice will also include information about how to file an appeal. Review this notice carefully, and follow the instructions to file an appeal.
You can file an appeal if you disagree with Medicare’s decision on payment or coverage for the items or services you got. If you appeal, ask your doctor, health care provider, or supplier for any information that might help your case. You should keep a copy of everything you send to Medicare as part of your appeal.
For more information on your right to a fast appeal and other Medicare appeal rights, look at your “Medicare & You” handbook or “Your Medicare Rights and Protections” booklet. To view or print this booklet, visit http://go.usa.gov/low. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.