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November 2, 2020

Reminder: Address All Redetermination Unfavorable Decisions When Submitting a Reconsideration Request

Please review each of the "Explanation of Decision" elements (as there may be more than one) on the redeterminations letter to address all of the reasons for the unfavorable decision(s) of the appeal. The redetermination letter outlines the reason(s) for the decision and the coverage criteria that must be met for the item to be considered for reimbursement. All reasons within the redetermination letter must be addressed when requesting a reconsideration, this will assist in processing at the next level of appeal.

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