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Help Appealing a Medicare Lab Denial

Medicare denied your lab claim and you're now responsible for the bill. You have the right to appeal — and a hard 120-day deadline. We're building a step-by-step appeal guide. Sign up to be notified when it's ready.

Don't wait. The clock is ticking.

You have 120 days from the date of the Medicare denial notice to file an appeal (called a "redetermination request"). Missing that deadline forfeits your appeal rights. If you're close to the deadline, contact 1-800-MEDICARE today.

What's coming in the full guide

Step-by-step instructions for filing a Medicare Redetermination Request (Level 1 appeal) before the 120-day deadline
What documentation to include — and where to find it
The five levels of Medicare appeal, when to use each, and the deadlines for every step
How to get a copy of the signed ABN from the lab (and what happens if they can't produce one)
Tips that improve approval rates, drawn from CMS guidance
Free, printable appeal templates you can fill in and send

Get notified when the guide goes live

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While you wait — tools that help right now

Both of these are free and available today. The data they return is exactly what you'll need for an appeal: what Medicare considers the test should cost, and whether the diagnosis codes on your lab order support coverage.

GougeStop Rate Lookup See the Medicare-allowed rate for the test you were billed for, plus what providers actually charge in your area. MedCarePrecheck Code Lookup → Check if the diagnosis codes on your lab order support Medicare coverage. Our affiliate site. MedCarePrecheck Bill Scanner → Upload your bill or lab order to see what Medicare would have paid and whether the coding looks right. Our affiliate site. Read: The ABN Trap How the Advance Beneficiary Notice form gets used to shift liability to patients.

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