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Appeals

Welcome to the WPS Medicare Appeals web page.


Reopening Phone Numbers
IL MI MN WI
(877) 867-3418
8:30 am to 11:30 am CT and
12:30 pm to 3:00 pm CT M-F
(877) 674-5416
8:30 am to 11:30 am CT and
12:30 pm to 3:00 pm CT M-F
(866) 380-4744
8:30 am to 11:30 am CT and
12:30 pm to 3:00 pm CT M-F
(877) 674-5354
8:30 am to 11:30 am CT and
12:30 pm to 3:00 pm CT M-F

Redetermination Requests
IL MI MN WI
WPS Medicare Part B
Appeals
P.O. Box 4433
Marion, IL 62959 - 0924
WPS Medicare Part B
Appeals
P.O. Box 5533
Marion, IL 62959 - 0965
WPS Medicare Part B
Appeals
8120 Penn Ave. S., Suite 200
Bloomington, MN 55431 - 1394
WPS Medicare Part B
Appeals
P.O. Box 1268
Madison, WI 53701 - 1268

Appeals Overview

Medicare allows beneficiaries, providers, and suppliers the right to appeal Medicare coverage and payment decisions. There are five levels of an Appeal.

  1. Redetermination by a Medicare carrier, fiscal intermediary (FI), or Medicare Administrative Contractor (MAC).
  2. Reconsideration by a Qualified Independent Contractor (QIC)
  3. Hearing by an Administrative Law Judge (ALJ) in the Office of Medicare Hearings and Appeals
  4. Appeals Council Review
  5. Judicial Review in Federal District Court

Appeals Information

Appeals for Glycated Hemoglobin A1C Tests, Procedure Code 83036
Duplicate Appeal Requests
How to Appeal a Claim Determination
How to Correct a Claim without Requesting a Reopening
How to Request a Reopening
How to Submit Your Appeal Request by Fax
Important Tips About Documentation When Submitting Appeals on C-SNAP
Redeterminations on Overpayments
Unprocessable Claim Rejections Do Not Have Appeal Rights
Who Receives the Reimbursement for Fracture Care?

CMS Resources

CMS Appeals Homepage
CMS Appeals Tri-Fold Brochure

Reopening Calculator

WPS Medicare offers a reopening calculator to assist with the appeals process. Please access this calculator by selecting "Resources" within the top navigation bar.

Medicare allows beneficiaries, providers, and suppliers the right to appeal Medicare coverage and payment decisions. There are five levels of Appeal.

Forms

*Appeals and related forms are available within the Forms option of the top navigation bar, including:

* Fax Form
* Reopening Request
* Redetermination Forms

Page Last Updated: Thursday, 26-Apr-2012 07:34:29 CDT