- Home»
- The Billing Beat Newsletter»
- Appeals = Redeterminations – The Medicare Part B Fee-for Service Appeals Process
Appeals = Redeterminations – The Medicare Part B Fee-for Service Appeals Process
July 1, 2004All first level appeals will now be called redeterminations. Redeterminations are the new first level of appeal under Section 521 of the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA).
The Medicare Part B Fee-for-Service Appeals Process
| Appeal Level | Time Limit For Filing Request | Monetary Threshold To Be Met |
| Review | 120 days from date of initial determination | None |
| Hearing Officer (HO) Hearing (Conducted by a contractor HO) | 6 months from date of review determination | At least $100 remains in controversy |
| Administrative Law Judge (ALJ) Hearing | Filed within 60 days of receipt of HO hearing decision | At least $100 remains in controversy |
| Departmental Appeals Board (DAB) Review | Filed within 60 days of receipt of ALJ hearing decision | None |
| Federal Court Review | Filed within 60 days of receipt of DAB hearing decision | At least $1000 remains in controversy |