The BIPA Appeals Process for Medicare Fee-for-Service beneficiaries and the Medicare Fast Track Appeal Process for Medicare Advantage Plan enrollees adhere to rigid CMS timeliness requirements.
To file an appeal, beneficiaries or their designated representatives are required to contact IPRO by noon of the day before the effective date on the Notice of Medicare Provider Non-Coverage (Medicare Fee-for-Service) or the Notice of Medicare Non-Coverage (Medicare Advantage Plans).
IPRO receives these appeals seven days a week, including weekends and holidays, between the hours of 8:30 am and 4:30 pm. An IPRO staff member then telephones or faxes our contact of record at the facility or provider. In appeals filed by Medicare Advantage Plan enrollees, we are in touch with our designated contact at the Plan.
To facilitate this process, and ensure that beneficiary appeals are completed on time, please be sure that your organization's contact information is current. When changes in designated IPRO appeals contacts occur, please complete a BIPA Termination of Services Form or a Medicare Advantage Form and return it to IPRO, attention Karen Sharpe, ksharpe@nyqio.sdps.org.
The Hospital Discharge Appeal process for Medicare Fee-for-Service beneficiaries and the Medicare Advantage Plan enrollees also adheres to rigid CMS timeliness requirements. To facilitate this process, and ensure that beneficiary appeals are completed on time, please be sure that your organization's contact information is current. When changes in designated IPRO appeals contacts occur, please complete a Hospital Discharge Appeal Contacts Form and return it to IPRO, attention Karen Sharpe, ksharpe@nyqio.sdps.org.