An official website of the United States government
Supporting documentation is required to complete the review of the dispute. The following list of documents would assist in processing your dispute request:
- Statute of limitations submitted by the insurer
- Physicians statement or discharge summary
- Independent medical exams
- Medical records
- Written statement defining similar injuries or pre-existing conditions
Note: If this case is in the Final Conditional Payment process, this means that a claim can only be disputed one time. To ensure the proper review of your disputed claim, it is in your best interest to provide complete and accurate supporting documentation at this time. Once the dispute is submitted, you will not have the option to submit additional documentation until after Medicare issues its final demand.
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