Medicare denied my claim, but I think the doctor’s office billed it wrong. Do I need to appeal?

Ask the billing office to check the claim, and keep track of the appeal deadline at the same time. A correction may resolve a claim submitted with wrong or missing information. An appeal asks Medicare or your plan to reconsider its decision.

Give the billing office the denied service, date and reason shown on your notice. Ask whether the information they submitted matches the care you received and whether they will send a corrected claim. Request confirmation of what they changed and when they sent it.

For Original Medicare, follow the appeal instructions and deadline on your Medicare Summary Notice. For Medicare Advantage, use your plan’s denial notice. Don’t let an unanswered call to billing be the reason you miss that deadline.

Keep copies of the notice, bill and any correction confirmation. If you still disagree with a denial, ask the doctor for records or an explanation that supports your appeal.