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In this section, you will learn about Medicare Advantage (MA) appeals, or appeals beneficiaries make to their Medicare Advantage Plan if the plan is denying a health care service or item that they would like to receive or have already received. You will learn about standard appeals for both pre-service and post-service denials. We will also review standard and expedited appeals and their applicable timelines.
After taking this section, you will be able to:
- Identify when a beneficiary may start a Medicare Advantage appeal
- Explain the difference between Medicare Advantage standard and expedited appeals
- Navigate expedited appeals for ending hospital care and ending non-hospital care
- Understand the steps in the different Medicare Advantage appeal processes
- Interactive activities and knowledge quizzes
- Review tests at the end of every section – 80% or higher mark to pass the section and download a certificate of completion
- Educational content vetted by a team of national experts at Medicare Rights Center
- Closed captioning
- An array of printable supplementary tools and fliers