Timeliness
Published 03/02/2021
Provider, beneficiaries, and suppliers all have the right to appeal the an initial claim decision. There are five levels of appeals, and each has a different time limit for filing. Here you can find information to determine the timeliness of your appeal.
| Appeals | Time Limit |
|---|---|
| Redetermination (initial appeal) | 120 days from the date of receipt of the initial claim determination notice. The notice of initial determination is presumed to be received 5 days from the date of the notice. |
| Reconsideration - Qualified Independent Contractor (QIC) |
180 days from receipt of the redetermination |
| Administrative Law Judge (ALJ) | 60 days from receipt of the QIC decision |
| Departmental Appeals Board Review (DAB)/Appeals Council | 60 days from the date of the ALJ decision or dismissal |
| Federal District Court Review | 60 days from the date of the Appeals Council decision |