South Dakota Petition for Hearing On Medical Benefits

• Category: South Dakota Workers Compensation - Official
• State: South Dakota
• Control #: SD-SKU-0684
• Format: PDF

Description

Petition for Hearing On Medical Benefits The South Dakota Petition for Hearing On Medical Benefits is a form used to request a hearing on a medical benefits dispute through the South Dakota Department of Social Services. This petition is used to appeal the decision of an insurance claim, Medicaid, or Medicare denial. It can also be used to appeal the amount of reimbursement provided for a medical bill. There are two types of South Dakota Petition for Hearing On Medical Benefits available: an Appeal for Review of Denial and an Appeal for Review of Amount of Reimbursement. The Appeal for Review of Denial is used when an insurance, Medicaid, or Medicare claim is denied. The Appeal for Review of Amount of Reimbursement is used when an insurance, Medicaid, or Medicare claim is approved, but the amount of reimbursement provided is disputed. Both forms must be completed and submitted to the South Dakota Department of Social Services.

The South Dakota Petition for Hearing On Medical Benefits is a form used to request a hearing on a medical benefits dispute through the South Dakota Department of Social Services. This petition is used to appeal the decision of an insurance claim, Medicaid, or Medicare denial. It can also be used to appeal the amount of reimbursement provided for a medical bill. There are two types of South Dakota Petition for Hearing On Medical Benefits available: an Appeal for Review of Denial and an Appeal for Review of Amount of Reimbursement. The Appeal for Review of Denial is used when an insurance, Medicaid, or Medicare claim is denied. The Appeal for Review of Amount of Reimbursement is used when an insurance, Medicaid, or Medicare claim is approved, but the amount of reimbursement provided is disputed. Both forms must be completed and submitted to the South Dakota Department of Social Services.