When “life, health, or ability to regain maximum function” is in jeopardy, you are entitled to a fast appeal (your appeal must be processed quickly if your doctor certifies the need):

Plan Reconsideration (Appeal)

• Must be requested within 60 days of receiving denial.
• Medicare private health plan has 72 hours (plus 14 days if it needs to gather information and it is in your best interest) to make a decision.
• Amount in question does not matter.

• Automatic review if plan upholds denial.
• Amount in question does not matter.
• IRE has 72 hours to respond.

• Must be requested within 60 days.
• Amount in question must be at least $140 in 2013.
• No time limit within which to respond.

• Must be requested within 60 days.
• Amount in question does not matter.
• No time limit within which to respond.

• Must be requested within 60 days.
• Amount in question must be at least $1,400 in 2013.