Help..just rec'd letter on my appeal
I need any info or any suggestions you have. I made an appeal because Medicare say my surgery was not medically necessary . I had a letter from my pcp who stated that it was, because my bmi was 40 and I had diabetes, high bp & arthiritis. medicare paid the hospital bill but denied the surgeons & the assiatant surgeons fee....so I appealed that. today I rec'd a ltr from the appeals board stating that they couldn't complete their review within 60 days so I have 2 options. # 1 do nothing and they will finish reviewing the appeal and send their decision. #2 I can choose to esclate my appeal to the next level, an admin law judge hearing. If you choose to esclate, we have 5 days to complete our reconsideration or we will send your case to an ALJ for a hearing. If your appeal is sent to the ALJ , the ALJ may take up to 180 days to make a decision. what would you do or has anyone encountered this b4? Thanks , Alice