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Medicare Appeals

Did the medical records support the service billed on your claim selected by the CERT, Recovery Auditors (RA), or Medicare contractor(s), but you still received an error? Were some of the documents missing from your original response to the documentation request which caused the claim to be in error?

If you receive an error on a claim selected by the CERT, RA or Medicare contractor, please review the medical records and determine if you agree with the results. If you disagree, you can appeal with your local Medicare contractor using the normal appeal process. Visit your local Medicare contractor’s website for any appeal forms and appeal process. Find your local Medicare contractors contact information and website address. For more information about the Medicare Part A and Part B administrative appeals process, please refer to the Medicare Learning Network® brochure Medicare Parts A & B Appeals Process [PDF, 1MB] .