Appeal & ALJ Hearing Preparation
Defend your Medicare billing privileges with expert strategy, documentation, and representation support.
Don’t Let a Revocation End Your Medicare Business
What Is an ALJ Hearing & Why It Matters for DMEPOS Suppliers
When a DMEPOS supplier receives a Medicare revocation, their only path to recovery is through the formal appeals process—which includes a hearing before an Administrative Law Judge (ALJ) if early appeals fail. Whether you’re challenging a PTAN deactivation, revocation due to site-visit issues, or documentation disputes, each level of appeal requires detailed filings, deadlines, and evidence that aligns with CMS expectations.
We prepare you for every stage—from reconsideration letters to ALJ hearing prep—with expert support, document organization, and regulatory insight.
Common Pitfalls & Costs
Why CMS Appeals Fail—and How Our Prep Process Makes a Difference
Most suppliers lose appeals because they don’t understand the formal structure CMS follows—or the depth of documentation required. Here’s what often goes wrong
Common Appeal Mistakes
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Missed Filing Deadlines
Each appeal level has tight deadlines—missing even one can forfeit your right to continue. -
Insufficient Documentation
General statements or partial documents are not accepted; CMS and ALJs require complete and well-organized evidence. -
Lack of Procedural Clarity
Suppliers unfamiliar with the five-level Medicare appeals process often misunderstand what's expected at each stage. -
No Corrective Action Plan
Without a clear plan to correct compliance issues, CMS rarely grants reconsideration or reversal.
Our Proven Prep Process
THE PROCESS
Our Step-by-Step Approach to Appeals & Hearings
01.
Revocation Assessment
We review your revocation letter, supporting evidence, NSC inspection notes, and PECOS status.
Reconsideration Filing
A complete response with evidence, credentials, and a Corrective Action Plan (CAP) is submitted to CMS on your behalf.
02.
03.
ALJ Docket Preparation
If reconsideration is denied, we gather, format, and file your defense packet per Office of Medicare Hearings and Appeals (OMHA) requirements.
Reduce CMS errors and protect your revenue
Medicare Appeal Benefits
Preserve your PTAN, protect your practice, and prepare your defense with confidence.
Need to appeal a PTAN revocation or prepare for an ALJ hearing?
Contact Us
Let's Talk Compliance
Everything you need to know about the Medicare DMEPOS appeal process
Frequently Asked Questions About Appeals & ALJ Hearings
What are the five levels of Medicare appeals?
Level 1: Redetermination → Level 2: Reconsideration → Level 3: ALJ Hearing → Level 4: Medicare Appeals Council → Level 5: Federal District Court
How long do I have to file a reconsideration request?
You must file a reconsideration within 60 days of receiving the initial revocation notice.
What happens during an ALJ hearing?
The ALJ reviews your case file, considers testimony and written evidence, and issues a new decision—often the first fully independent review of your case.
Can I reinstate my PTAN during the appeal?
No, your PTAN remains deactivated until you win the appeal or reapply—however, we can help prepare for reactivation post-decision.
Can you help if I already missed a deadline?
In some cases, yes. If it’s within 30 days past due, we may be able to request good-cause reinstatement. Contact us immediately.