Frequently Asked Questions

Question 1: What is a reconsideration? 

Answer:  A reconsideration is the second level in the 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 decisions made by Durable Medical Equipment Medicare Administrative Contractors (DME MACs).  RiverTrust’s review is the reconsideration.  Reconsideration is only done after the DME MAC renders a first level review called a redetermination.

Question 2: Do I need to use the standard reconsideration form or can I simply submit the request in writing?

Answer:  The standard reconsideration form includes all information necessary to submit a request. However, use of the form is optional but must include the necessary elements to be valid.

Question 3: How will I know that RiverTrust has received my reconsideration request?

Answer:  RiverTrust has 14 calendar days to acknowledge your reconsideration request by letter. Please allow 14 calendar days to hear back from us.

Question 4: I submitted a reconsideration request and have not heard anything. What should I do?

Answer:  If more than 14 calendar days have passed and you have not received a response from RiverTrust, you may send a letter to us. Be sure you are writing to the correct QIC. RiverTrust handles reconsiderations for Durable Medical Equipment appeals.

Question 5: How do I check the status of my reconsideration? 

Answer: 

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

Provider:  You may check the status of the reconsideration request by going to the “Providers: Appeal Status Information (off site) section of www.Q2A.com (off site). Enter the reconsideration Medicare Appeal Number in the search field.

Search results only include the following basic information about an appeal: date received, appeal status, and deadline. Privacy laws prohibit the display of any protected health information (PHI).

A Provider does not need a login to view the status of an appeal. All information for providers is located on the public site of the Q2A.com Web site.

Question 6: Where can I find my reconsideration appeal number?

Answer:  You will find the reconsideration appeal number in the upper right-hand corner of the acknowledgement letter sent by the QIC handling your case.

Question 7: Can I submit additional information?

Answer:  You may file additional information within 14 calendar days in receipt of your acknowledgement letter.

Question 8: How long does it take RiverTrust to make its decision?

Answer:  RiverTrust has 60 calendar days to make a decision. If we cannot complete the reconsideration within that time frame, you have the opportunity to escalate the request to an Administrative Law Judge (ALJ) hearing.

Question 9: How can I request a copy of a decision letter?

Answer:  You can fax a request or email us and give us the Medicare appeal number and contact information and we will send you a copy of the decision letter.

Question 10: If I disagree with my decision, what is the next step?

Answer:  If you disagree with the outcome of your Level 2 appeal (called a reconsideration in Parts A & B/Original Medicare, and D/Prescription Drug Plan and a reconsidered determination in Part C/Medicare Advantage), you or your representative can request a hearing before an Administrative Law Judge (ALJ).  This is Level 3 of the claims appeal process. You can visit their website at www.hhs.gov and find Office of Medicare Hearing and Appeals.