Medicare denied a claim.
Now you appeal.
The denial notice is two pages. The redetermination request — the first level of Medicare appeal — is the rest of the work. You read your loved one's records, find the operative policy language, build the medical-necessity argument, and watch the 120-day filing window. Health Agent does that work in your account so you stay with the person.
Upload a photograph of the Medicare denial. Health Agent extracts the denial reason code, drafts the redetermination request grounded in the patient record on file, and Knox-anchors the source document in a Bitcoin-rooted hash chain so the appeal timeline is independently verifiable. The caregiver reviews the draft, edits if needed, and submits it to the Medicare Administrative Contractor address on the denial notice.
Five levels, five different windows.
Medicare appeals are governed by the Centers for Medicare & Medicaid Services and follow a five-level structure. Each level is heard by a different body, has its own filing deadline, and — at higher levels — has a minimum amount-in-controversy threshold. The deadlines below apply to Original Medicare (Parts A and B); Medicare Advantage and Part D timelines differ.
- Redetermination Reviewed by the Medicare Administrative Contractor (MAC) that issued the denial. Filing deadline: 120 days from the date of the denial notice.
- Reconsideration Reviewed by a Qualified Independent Contractor (QIC), independent of the MAC. Filing deadline: 180 days from the redetermination decision.
- Administrative Law Judge hearing Heard by an Administrative Law Judge at the Office of Medicare Hearings and Appeals. Filing deadline: 60 days; minimum amount in controversy applies (set annually by CMS).
- Medicare Appeals Council review Reviewed by the Medicare Appeals Council within the Departmental Appeals Board. Filing deadline: 60 days from the ALJ decision.
- Federal district court Civil action in federal district court. Filing deadline: 60 days; higher minimum amount in controversy (set annually by CMS).
Health Agent helps with the document and timeline work. For an appeal at Administrative Law Judge level or beyond, retain qualified counsel familiar with Medicare appeals. Health Agent does not provide legal advice and does not act as the beneficiary's legal representative.
Four steps. The caregiver stays in control.
- 1. You photograph the denial letter. The Medicare Summary Notice or denial letter goes in the same document inbox as the rest of the patient's records — a phone photograph is enough. AI vision reads pixel-level content and classifies the document type.
- 2. Health Agent extracts the denial reason code. Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) are pulled from the document and resolved against an internal taxonomy that maps each code to the operative argument types — medical necessity, coding error, coverage policy, timely filing, and so on.
- 3. The appeal letter is drafted. Medical-necessity arguments are built from the patient record on file: uploaded documents and any FHIR data the beneficiary has connected through Epic MyChart, Oracle Health (Cerner), Medicare Blue Button, or athenahealth. Operative payer policy language is cited where the denial code maps to it — including Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) for coverage-related denials. The writer is payer-agnostic; Medicare-specific tuning is an active engineering build, not a present capability. The output is a draft letter, not a filing.
- 4. The caregiver reviews, edits, and submits. The draft is editable. The caregiver — or the beneficiary — submits the final letter to the MAC address printed on the denial notice. Health Agent does not file on the beneficiary's behalf.
The denial existed before the appeal. Prove it.
Every denial letter ingested into Health Agent is hashed with SHA-256, recorded in a per-stream
hash chain, rolled into a Merkle tree, and submitted to the Bitcoin blockchain via
OpenTimestamps. The Knox event for the ingestion is named
APPEAL_EOB_INGESTED and its payload is the cryptographic hash of the source
document.
If the case advances to Administrative Law Judge hearing — Level 3 — the timeline is independently verifiable. A reviewer can confirm, using public Bitcoin tooling and without trusting Bonis Systems, that a specific denial document existed in a specific form on a specific date, before the appeal was drafted from it. The chain does not prove the appeal is correct; it proves the source document is the source document.
Knox is the Bonis cryptographic audit-permanence primitive. USPTO provisional 64/038,359. The same primitive anchors evidence on TerraVault, TrustAi, and DealMatcher.
Common questions from caregivers.
Does Health Agent submit the appeal to Medicare for me?
No. Health Agent drafts the appeal letter and assembles the evidence packet. The caregiver — or the Medicare beneficiary themselves — submits to the Medicare Administrative Contractor address printed on the denial notice. Health Agent does not act as the beneficiary's legal representative and does not file on the beneficiary's behalf.
Is Health Agent endorsed by Medicare or CMS?
No. Health Agent is operated by Bonis Systems LLC, an independent Wyoming-registered firm. There is no endorsement, affiliation, or partnership with the Centers for Medicare & Medicaid Services, the Social Security Administration, or any Medicare Administrative Contractor.
How is patient data protected?
Traffic is HTTPS-only with HSTS preload. Patient identifiers (name, date of birth) are encrypted at the application layer with AES-256-GCM before they hit the database. Underlying object storage applies the cloud provider's default AES-256 at-rest encryption. Knox-anchoring records the SHA-256 hash of the source document on a Bitcoin-rooted hash chain — the hash, not the document content. The document itself is not published anywhere. See the privacy policy at /privacy.html for the full data handling description.
Does Health Agent give legal advice?
No. Health Agent is software that drafts appeal letters and assembles evidence packets from the patient record. It is not a law firm, does not employ attorneys, and does not provide legal advice. For an appeal at Administrative Law Judge level or beyond, retain qualified counsel familiar with Medicare appeals.
What does it cost?
Account creation is free. Tiered pricing for paid features is published at /pricing.html. Knox-anchoring is included on every appeal at every tier — including the free tier — because the audit chain is the integrity primitive, not a paid add-on.
A 120-day window is shorter than it looks.
Account creation is free. Photograph the denial. Health Agent does the document and timeline work; you read the draft, edit if needed, and submit. The caregiver stays with the person.