How are the Centers for Medicare & Medicaid Services (CMS) medical denial letters to be delivered?
Denial letters must be delivered to the beneficiary or to the person acting on his or her behalf as Power of Attorney or Social Security Representative Payee. If attempts to deliver the letter in person are not successful, the facility should make a telephone contact, then send the denial letter via certified mail on the same day. The provider should document on the denial letter the name of the person contacted and the date of the telephone contact. If the person contacted is the responsible party (rather than the beneficiary), the provider should indicate whether the contact is the Power of Attorney or the Social Security Representative Payee.
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