Audience:

DO/BO/TSC:
CR, CR TII, FR, OA, OS, RR, SR
OCO-ODO-IND:
DEC, DS, EHI, RCOVTA, RECONR
OCO-ODO-SHARE:
BA, DE, RECONE, RECOVR
OCO-OIO:
CA, CATA, FCR, FDE
OEO:
ADOCPA, DCCRC
PSC:
CRTA, CS, DE, IES, RECONR

BASIC (02-82)

GN 04060.001 How Medicare Reopenings May Occur

A party whose right to reconsideration, review, and/or hearing has expired and to whom no extension of time has been granted may express dissatisfaction with a denial or the amount of the payment, or additional information pertinent to a determination or decision may be brought to light. If dissatisfaction is expressed before the right to reconsideration, review, or hearing has expired, it is handled in accordance with as appropriate. If dissatisfaction is expressed after the right to reconsideration, review, or hearing has expired, or an intermediary, a carrier, or a hearing officer (or the Center for Medicare and Medicaid Services for Part A claims) determines on its own motion that a determination or decision may be erroneous and should be reopened, the procedures in GN 04060.005 through GN 04060.065 apply.

References:


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204060001
GN 04060.001 - How Medicare Reopenings May Occur - 02/08/2012
Batch run: 02/08/2012
Rev:02/08/2012