Form for Expedited Appeals: Lighting a Fire Under Medicare Advantage Plans

Brian Moore, M.D., medical director of utilization management and physician advisor services at Atrium Health in North and South Carolina, now faxes all requests for expedited appeals of pre-service benefit denials to Medicare Advantage plans rather than requesting them over the phone, and includes a brief description of the reason why the patient requires post-acute care. More documentation will be provided on request, but the clock is ticking because the MA plan has to decide on the appeal in 72 hours. He prefers the paper trail that comes with faxes (“Faxing One-Page Expedited Appeals to MA Plans Is New Strategy for PA,” RMC 28, no. 27). Contact Moore at brian.moore@atriumhealth.org.

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