Which Form Do I Use?

Published 03/02/2021

Do you need to submit a redetermination or a written reopening? Find resources, links and instructions to assist you with selecting the proper appeals form.

Find Railroad Medicare forms on our website. Answer simple questions to determine which form to use for your appeals scenario. Many of these forms are also available as eForms in our eServices portal.  

Railroad Medicare Appeals forms include:

  • Redetermination: 1st Level Appeal
  • Redetermination: 1st Level Appeal - Late Submission
  • Redetermination: Comprehensive Error Rate Testing (CERT)
  • Redetermination: Comprehensive Error Rate Testing (CERT) - Late Submission
  • Redetermination: Overpayment Appeal
  • Redetermination: Overpayment Appeal - Late Submission
  • Reopening: Simple Claim Correction
  • Reopening: Simple Claim Correction - Late Submission

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