Appeal Process
Published 09/29/2023
The Review Choice Demonstration (RCD) does not include a separate appeal process. A non-affirmation decision is not appealable. As a reminder, a non-affirmed pre-claim review decision does not prevent the Inpatient Rehabilitation Facility (IRF) RCD provider from submitting a final claim. A submission of a final claim with a non-affirmed unique tracking number (UTN) and resulting denial by Palmetto GBA would constitute an initial determination on the claim that would make the appeals process available.