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Provider Enrollment Appeals and Rebuttals - Revised Instructions and Model Letters

The purpose of this CR is to clarify Medicare Administrative Contractor (MAC) procedures for processing provider enrollment appeals and rebuttals. This CR clarifies MAC External Monthly Reporting Requirements for Rebuttals and Appeals. This CR also provides clarifying instruction regarding Model Letters. In addition, this CR creates additional appeals and rebuttal model letters.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 07, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.