Notice requirements for CMS non-contracted provider appeals for zero net payment- MMCM Chapter 13, 40.2.3
Non-contracted providers have the right to request a reconsideration for denial of payment within 60 calendar days from the remittance notification date to file the reconsideration. A signed Waiver of Liability form holding the enrollee harmless regardless of the outcome of the appeal is required.  Please complete the Waiver of Liability form and submit to the health plan.