Withdraw of an Appeal Request

A request for a redetermination may be dismissed under the following circumstances.
  • At the Request of the Party

    A request for redetermination may be withdrawn at any time prior to the mailing of the redetermination upon the request of the party or parties filing the request for redetermination.  You must submit the request in writing. A letter documenting your request to withdraw the appeal will be issued and will provide you with the criteria that must be met if you wish to review the service at another time.

  • Failure to File Timely

    When a request for a redetermination is not filed within the required time limit (120 days from the date of the initial determination) and good cause for failure to file timely was not found by the FI or MAC, the request will be dismissed.  It is the responsibility of the individual filing the request to provide information to support the late filing request.

  • Party Failed to Make a Valid Request
    When it is determined that the provider failed to submit a valid request for redetermination as identified in Section 1.1, the request will be dismissed.  You may file your request again with the required information if it has been 120 days or less since the date of receipt of the initial determination.

  • Appeal Rights for Dismissals
    You may request that we vacate our dismissal within 6 months of the date of the mailing of the dismissal notice if you think you have good and sufficient reason to dispute the dismissal.  You also have the right to appeal a dismissal to the Qualified Independent Contractor (QIC) if you believe it was incorrect.  The reconsideration request to the QIC must be filed within 60 days of the date of the dismissal.  The dismissal letter will provide you with detailed information regarding your options and the time frames for each option.