[Fredslist] Medicare Appeal assistance

[Gideon Schein]

Dear Gothamites:

I have been helping out a friend with her mother who 30 years ago had palate
cancer, which necessitated putting in a prosthetic dental prosthesis and
various other dental work to support the prosthesis.  The initial costs were
covered by her insurance.  Since she turned 65 she needed to have upkeep
procedures, which were denied as "medically unnecessary procedures."  Each
time we put a lengthy appeal together, which was automatically denied, and
then on appeal was reversed by a claims analyst or an administrative law
judge, following an appearance.  In July of 2009, she needed further work,
which was denied again, only this time using Medicarespeak that even I
cannot understand.  Is there anyone out there who can help me translate the
denial into language we can understand so that we can properly appeal for
another appearance to an Administrative Law judge?  Or, is there a
particular number to call, besides the usual suspects, that will simply
clarify the language.  I am not looking for our appeal, just an
understanding of the denial.

We need to get the appeal in by March 6th so if you can help me, call me at
212-316-2214 or on my cell so that we can talk.

Thanks so much for your help.

Gideon

-- 
Gideon Y. Schein, M.B.A., P.D.M.M.
Certified Professional Daily Money Manager
Eddy & Schein In-Home Administrators for Seniors®
Life Keeping, Not Just Bookkeeping®
431East 118th St. #1
New York, NY 10025
Tel: 212-316-2214
Fax: 212-662-9909
www.eddyandschein.com
gideon at eddyandschein.com
Member, American Association of Daily Money Managers
Member, National Association of Professional Organizers
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