Rachel Hold-Weiss
speaker
223 appearances
1 recordings
1 series
first heard Jul 2026
last heard 10 Jul
Rachel Hold-Weiss’s voice in public audio — every appearance, attributed to the second.
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recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.
Appearances
There are five levels of appeal.
The first level is a redetermination and that is after the MAC sends a demand letter.
So
The UPIC will issue a decision, and then at some point, it could be quick, it could be longer, depending on who the MAC is, you're going to get a letter from, the provider will get a letter from the MAC saying, you owe us X amount of dollars.
Usually that dollar amount matches the UPIC audit findings.
There are times that it hasn't, and that's a whole process in and of itself.
And then the next level of appeal is called a reconsideration.
Then you have administrative law judge or ALJ appeal.
Then you have the Medicare Appeals Council or DAB.
And then you have federal district court.
And the appeals process is lengthy.
It is costly.
It is very time consuming.
But most importantly, what a lot of providers don't know is when they get those letters,
if they get them, because sometimes they get stuck somewhere and they don't even get those demand letters and then recruitment begins, is the timeframe that's identified on those letters at the first two levels, the redetermination, the demand letter, and then a redetermination decision.
They tell you at the demand letter that if you want to appeal or if you get an EOB in certain cases, it'll say you have 120 days.
to appeal.
What they don't tell you is if you don't file an appeal, if they don't have it on record by within 30 days, and then recoupment will begin.
And then same thing at the next level of appeal.
It says you have 180 days to file, but if you don't have it in within 60 days, then recoupment will begin.
Showing 41–60 of 223 · page 3 of 12
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