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  • Posting Date: 04/12/2021
    Website Feedback Form

    Website Feedback Form We value your feedback about our website. Please tell us about your experience and provide any suggestions for improvement. This form is for the submission of feedback regarding your recent website experience; it [...]

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  • Posting Date: 01/26/2021
    RM 3_HHH_Who May File an Appeal

    What if the Appointment of Representative Form Is Incomplete or Defective? If the Represented Party is the Provider The MAC notifies both the person submitting the appointment and the provider that the appointment is incomplete or defective. [...]

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  • Posting Date: 01/27/2021
    RM 2_A-HHH-FQHC_Who May File an Appeal

    Required Elements The following information must be included on an Appointment of Representative (CMS-1696) form or written statement: Name, address, phone number of party (i.e., the beneficiary, facility, physician, or other supplier) NPI [...]

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  • Posting Date: 01/26/2021
    RM 1_A-HHH-FQHC_Who May File an Appeal

    When Is an Appointment Not Necessary? When Is an Appointment Not Necessary? Billing clerks or billing services employed by the provider or supplier to prepare and/or bill the initial claim, process the payments and/or pursue appeals act as the [...]

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