RiverTrust

Your Medicare Appeal Rights

You have the right to appeal any decision about your Medicare services. If Medicare does not pay for an item or service you have been given, or if you are not given an item or service you think you should get, you can appeal.

Appeal Rights Under the Original (Fee For Service) Medicare Plan:

If you are enrolled in the Original Medicare Plan, you can file an appeal if you think Medicare should have paid for, or did not pay enough for, an item or service you received. If you file an appeal, ask your doctor or provider for any information related to the bill that might help your case. Your appeal rights are on the back of the Explanation of Medicare Benefits or Medicare Summary Notice that is mailed to you from a company that handles bills for Medicare. The notice will also tell you why your bill was not paid and what appeal steps you can take.

Transfer of Appeal Rights

A beneficiary may decide to transfer his or her rights to appeal the claim to the Medicare provider that performed the service. For more information, please see: Transfer Appeal Rights

Beneficiary Frequently Asked Questions

Q: What is a reconsideration?

A reconsideration is the second level in the revised Medicare appeals process. An appellant may file a request for reconsideration if he or she is dissatisfied with the results of the Medicare contractor's redetermination. RiverTrust reviews reconsiderations for Durable Medical Equipment Medicare Administrative Contractors (DME MACs).

Q: Where can I find a reconsideration form?

Click here to download a standard reconsideration form.

Q: I’ve received an acknowledgement letter from RiverTrust. How do I check the status of my reconsideration? Do I need a login to view the status of an appeal?

You can call 1-800-Medicare (1-800-633-4227) to check the status of the reconsideration.