Good Morning Amanda,
We have had success with the ALJ several times; usually it takes at least 90 days to see your payment returned once they’ve issued a decision. We had to call the Noridian customer service line several times to make sure they had received the appeal information from the ALJ and were going to refund the money back to us. It took them a couple of months, but they did refund us. As far as interest, etc…, they will automatically calculate & pay interest to you. We recouped $60,000 on a prosthetic at the ALJ level and were paid back over $7,100 in interest alone by Medicare. At this point, as far as hearing turnaround times, they are battling extreme backlog. We are still waiting for hearings to be scheduled on appeals that we submitted to the ALJ over 9 months ago. The waiting process can definitely be lengthy for a hearing and from what we’ve been told by various ALJ personnel, there is no specific timeline that they’re required to follow. The longest ALJ process that w!
e’ve experienced thus far from filing through receiving the decision letter was approximately 18 months.
I hope this helps!
Leah Racho
Medicare Specialist
Pacific Medical, Inc
1700 N Chrisman Road
Tracy, CA 95304
Ph (800) 726-9180 ex. 7310
Fax (209) 221-6189
[email protected]
“Be the change you want to see in the world”
-Gandhi
—–Original Message—–
From: Orthotics and Prosthetics List [mailto:[email protected]] On Behalf Of Amanda Springer
Sent: Tuesday, April 09, 2013 3:41 PM
To: [email protected]
Subject: [OANDP-L] After the ALJ???
Hello List,
I apologize in advance if this has previously been covered. I looked and didn’t see anything specifically regarding my question so here goes:
To all who have successfully finished the ALJ process and had their cases overturned (Congratulations!) –
1.) Once you have received your notification that you were successful what is the next step?
2.) How long until your monies have been paid back by Medicare?
3.) Have any of you charged administrative fees, interest and/or legal fees? If so, how did you notify them that you would do this and how did you calculate such fee’s?
Any information would be helpful. We submitted the first of several ALJ Appeals in November 2012 and are still waiting to hear when our case will be heard. It would be nice to know what kind of time line we are looking at.
Thank you in advance for your responses.
Amanda
******************** To unsubscribe, send a message to: [email protected] with the words UNSUB OANDP-L in the body of the message.
If you have a problem unsubscribing,or have other questions, send e-mail to the moderator Paul E. Prusakowski,CPO at [email protected]
OANDP-L is a forum for the discussion of topics related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries should not be sent to the entire oandp-l list. Professional credentials or affiliations should be used in all communications.
The documents accompanying this email transmission are CONFIDENTIAL.
Information contained in this email transmission belongs to the facility sending the data and is legally privileged. The information accompanying this email transmission is intended only for the use of the individual (or facility) identified as “recipient”. The recipient of this information is prohibited from disclosing, copying, distributing or using this information except as permitted by current law governing privacy of information issues. Such information must be destroyed after its stated need has been fulfilled, unless otherwise prohibited by law.
If you have received this email transmission in error, please notify the “sender” immediately for return instructions at 800 726-9180.
