If its close to the end of the time limit and your doctor or supplier still hasnt filed the. Ask for the exact time limit for filing a Medicare claim for the service or supply you got. If they dont file a claim, call 1-800-MEDICARE. Contact your doctor or supplier, and ask them to file a claim. You will receive directions from the Quality Improvement Organization (QIO) regarding additional appeal options. If the claims arent being filed timely: 1. The Quality Improvement Organization will respond to you as soon as possible, but no later than 14 days after receiving your request for a second review. You may ask for this review immediately, but must ask within 60 days after the day the Quality Improvement Organization said no to your Level 1 Appeal. Within 48 hours the reviewers will tell you their decision. When you'll hear back from the Quality Improvement Organization (QIO) (Please refer to above directions regarding filing an expedited appeal) As a result of the Patient Protection and Affordable Care Act (PPACA), all claims for services furnished on/after January 1, 2010, must be filed with your Medicare Administrative Contractor (MAC) no later than one calendar year (12 months) from the date of service (DOS) or Medicare will deny the claim. ![]() If you miss the deadline for contacting the Quality Improvement Organization about your appeal, you can make your appeal directly to us instead. You must contact the Quality Improvement Organization to start your appeal no later than noon of the day after you receive the written notice telling you when we will stop covering your care. You can ask to change this decision so you're able to continue coverage. When your coverage for that care ends, we'll stop paying our share of the cost for your care. You’ll receive a "Notice of Medicare Non-Coverage (NOMNC)" in writing at least 2 days before we decide it’s time to stop covering your care. ![]() (Usually, this means you’re getting treatment for an illness or accident, or you're recovering from a major operation.)
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