How Do You Appeal A Medicare Enrollment Rejection?
Medicare enrollment is the essential first step before physicians, providers and suppliers can bill Medicare. Enrollment applications are processed by the Medicare claims processing contractors for the provider jurisdiction. Medicare enrollment denials can bring financial disaster to health care providers seeking to treat Medicare beneficiaries. Recognizing this potential impact, Congress enacted the enrollment appeals provisions of the Medicare Prescription Drug, Modernization and Improvement Act of 2003. Any provider whose Medicare billing privileges are revoked or whose enrollment application is denied has a right to appeal the determination. Aggrieved parties must exhaust all administrative processes before filing a case in court. Review any denial or revocation letter sent from the Medicare contractor that made the adverse determination. The denial letter contains the reasons for rejecting the provider’s enrollment application, and provides information on the appeal process. Revoc
