The Quality Improvement Organization will respond to you as soon as possible, but no later than 14 days after receiving your request for a second review. You may ask for this review immediately, but you need to ask within 60 days after the day the Quality Improvement Organization said no to your Level 1 Appeal. Within 48 hours the reviewers will notify you of their decision. (Please refer to above directions regarding filing an expedited appeal) If you miss the deadline for contacting the Quality Improvement Organization about your appeal, you can make your appeal directly to us instead. You must contact the Quality Improvement Organization to start your appeal no later than noon of the day after you receive the written notice telling you when we will stop covering your care. You can ask to change this decision so you're able to continue coverage. When your coverage for that care ends, we'll stop paying our share of the cost for your care. You’ll receive a "Notice of Medicare Non-Coverage (NOMNC)" in writing at least 2 days before we decide it’s time to stop covering your care. (Usually, this means you’re getting treatment for an illness or accident, or you're recovering from a major operation.) Rehabilitation care as an outpatient at a Medicare-approved Comprehensive Outpatient Rehabilitation Facility (CORF). Basically, a waited claim is an active claim that’s pending until important information is provided.You may read more about how to avoid duplicate claims submissions at Claims Corner on. Providers may check the status of a prior claim submission by signing in to /providers and using the Claim Search drop-down under the Claims tab, or calling a Provider Customer Service representative. Skilled nursing care as a patient in a skilled nursing facility Meritain health claims timely filing limit.You have the right to keep getting your covered services for as long as the care is needed to diagnose and treat your illness or injury if you’re getting:
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