In this LTC NAC Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss the Medicare appeals process in skilled nursing facilities.

Additional Resources:

Medicare Parts A & B Appeals Process: How the Five Levels of Appeal Work – AAPACN Article

Medicare Advantage vs. FFS Part A Expedited Determinations: What’s the Difference? – AAPACN Article

RAC-CTA - Medical Reviews and Oversight for the Advanced Medicare Specialist - Online + PDF – AAPACN On-Demand Course

Medicare Basic Training Part 9: Beneficiary Notices Initiative On-Demand Workshop – AAPACN Training

Medicare Basic Training Part 10: Medical Review and Appeals On-Demand Workshop – AAPACN Training

Original Medicare (Parts A and B Fee-for-Service) Initial Determination/Appeals Process – CMS Flow Chart

Beneficiary Notices Initiative – CMS Forms and Instructions for Notices

CMS Levels of Appeal – Website Reference