1. How to Appeal a Medicare Claim Denial

If Original Medicare or your Medicare Advantage plan ever denies a claim, don’t panic. Whether you’re on Original Medicare or a Medicare Advantage plan, most denials can be fixed with the right documentation and help. You always have the right to appeal, and with the right steps, many of these situations get resolved.

The appeal process has a few stages, starting with a request for reconsideration. If that doesn’t get the result you need, it can move to an administrative law judge, then the Medicare Appeals Council, and even federal court if necessary. The key is meeting every deadline and making sure all the right paperwork is included.

This is something I help my clients with whenever it comes up. Thankfully, this is quite rare, and when it's happened I have been able to get things overturned in my clients favor. If you ever have a Medicare claim denied and are a client of mine, I can guide you through each step, help organize your documentation, and give you the best chance of getting the claim approved. Call me at 615-579-7592 or email joel@wellnessinsurance.info if you ever run into this, and I’ll make sure you’re not handling it alone.