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.
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GN 03108.200 Title XVIII Medicare Fee-For-Service (FFS) Appeals