Medicare Claims Processing Manual (Pub. 100-04), Ch. 29 § 310.2

Time Limit for Filing a Request for Redetermination

Last amended: 2019Year: 2019Length: 419 wordsOfficial source
310.2 - Time Limit for Filing a Request for Redetermination (Rev. 4278, Issued: 04-12-19, Effective: 06-13-19, Implementation: 06-13-19) A party must file a redetermination request within 120 days of the date of receipt of the notice of initial determination (MSN or RA) with the contractor indicated on the notice of initial determination (receipt of the notice of initial determination is presumed to be 5 days after the date of the MSN or RA unless there is evidence to the contrary). The date of filing for requests filed in writing is defined as the date received by the appropriate contractor in the corporate mailroom, the date received via facsimile, or the date received in the secure Internet portal/application, as evidenced by the receiving office’s date stamp on the request. If the party has filed the request in person with the contractor, the filing date is the date of filing at such office, as evidenced by the receiving office’s date stamp on the request. If the party has mailed or filed in person the request for redetermination to a CMS, SSA, RRB office, or another contractor or Government agency within the time limit, and the request did not reach the appropriate contractor until after the time period to file a request expired, the contractor shall consider the date the request was first filed with a contractor or an official Federal government entity as the date of receipt for purposes of determining if the redetermination request was filed in a timely manner. When the filing deadline for a redetermination ends on a Saturday, Sunday, legal holiday, or any other nonwork day, the contractor shall apply a rollover period that extends the filing deadline to the first working day after the Saturday, Sunday, legal holiday, or other nonwork day. For example, if the filing deadline for a redetermination falls on the Saturday before Columbus Day, the filing deadline is extended to the first working day after the Columbus Day holiday. The contractor may extend the period for filing if it finds the party had good cause for not requesting the redetermination timely. (See §240.2 for a discussion of good cause.) In order for good cause to be considered, the appeal request must be in writing, received via hard copy mail, through a facsimile, or through a secure Internet portal/application. If the contractor finds that the party did not have good cause for failing to request a redetermination in a timely manner, it may, at its discretion, consider reopening. (See Pub. 100-04, chapter 34.)
Medicare Claims Processing Manual (Pub. 100-04), Ch. 29 § 310.2: Time Limit for Filing a Request for Redetermination | Justis AI