Timeliness of Appeals (Redeterminations)
Is your work day hectic? Do you have deadlines to meet? To ensure that your appeal (redetermination) is considered for review, we need to receive them within 120 days of the date of the initial determination. If you want to request an appeal for a service that you have submitted several different claims for, we calculate the 120 days from the earliest finalized date on the remittance for the claim submitted for that service.
Additionally, a claim can not be considered "denied" if the claim was returned as "unprocessable." Unprocessable claims can be corrected and resubmitted. Watch your remittance notice for returned or denied claims and submit your appeals timely.
