Timely filing applies to both initial and re-submitted. OMHA provides additional information on other levels of appeals to help you understand the appeals process in a broad context. Non-Institutional claims are subject to a timely filing deadline of 180 days from date of service. OMHA is not responsible for levels 1, 2, 4, and 5 of the appeals process. HumanaMedicare will extend the timely filing limit through the last day of. Please note that the Office of Medicare Hearings and Appeals is responsible only for the Level 3 claims appeals and certain Medicare entitlement appeals and Part B premium appeals. Timely Filing Limits Cheat Sheet when to submit claims and appeals by payer. If during your Level 1 appeal ("reconsideration") your Medicare Advantage plan does not decide in your favor, it is required to forward your appeal to an independent outside entity for a Level 2 review. If your Medicare Advantage plan fails to meet the established deadlines, it is required to forward your appeal to an independent outside entity for a Level 2 review. Your plan does not meet the response deadline. Your Level 1 appeal ("reconsideration") will automatically be forwarded to Level 2 of the appeals process in the following instances: If you are receiving services in an inpatient hospital, skilled nursing facility, home health agency or comprehensive rehabilitation facility, you may request an immediate review by a Quality Improvement Organization, if you disagree with your Medicare Advantage plan's decision to discharge you or discontinue services. You or your physician may request an expedited reconsideration by your Medicare Advantage plan in situations where the standard reconsideration time frame might jeopardize your health, life, or ability to regain maximum function. Special Circumstances for Expedited Review
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