Nonprofit ยท Center for Medicare Advocacy
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
Know before you go
The page lists three comprehensive toolkits: home health coverage, outpatient therapy coverage and skilled nursing facility coverage, each tied to the Jimmo v. Sebelius court case, and it also mentions an Improvement Standard self-help packet. It does not describe a helpline or individual casework. The cost is not stated on the page. The materials are about Medicare only, and we did not read the packets themselves.
- Cost
- Not stated
- Where
- Nationwide
- How to start
- Open the page, choose the toolkit that matches the care that was reduced or denied, and use it to prepare your appeal or a conversation with the facility.
- Have ready
- The notice that says coverage is ending or was denied; Your doctor's orders and therapy notes; Your Medicare card
Where this comes from
- Provider
- Center for Medicare Advocacy
- Source we read
- https://medicareadvocacy.org/take-action/self-help-packets-for-medicare-appeals/
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
From Centers for Medicare & Medicaid Services
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Coverage Rights state-by-state appeal steps
A nonprofit website that gives each state's steps for appeal, external review and complaint when an insurer denies or delays a treatment, with a focus on medicines. No helpline or letters.
From Aimed Alliance