Appealing Cost Report Audits
If you are dissatisfied with a final determination of the audit of your cost report by Cahaba or the Centers for Medicaid and Medicare Services (CMS) you have the right to appeal the decision by requesting a fiscal intermediary hearing or a provider reimbursement review board hearing.
Fiscal Intermediary Hearing
The issue(s) appealed involves at least $1,000 but less than $10,000 in program reimbursement
A request for an intermediary hearing should be submitted to:
Intermediary Hearing Officer
Reimbursement and Provider Appeal Department
Blue Cross and Blue Shield Association
225 North Michigan Avenue
Chicago, Illinois 60601
Send a copy to Cahaba at the address listed on the "Write Us" page under Provider Audit and Reimbursement / Financial.
Provider Reimbursement Review Board (PRRB) Hearing
The issue(s) appealed involves $10,000 or more in program reimbursement. Or a group issue (s) appealed with an aggregate claim of $50,000 or more in program reimbursement.
The Provider Reimbursement Review Board is an independent panel.
A decision of the board may be affirmed, modified, reversed or vacated and remanded by the CMS administrator within 60 days of notification to the provider of that decision.
PRRB
instructions 
are available on the CMS Web site.
A request for a PRRB hearing should be submitted to: (send to both parties):
Chairman
Provider Reimbursement Review Board
2520 Lord Baltimore Drive
Suite L
Baltimore, Maryland 21244-2670
and
PRRB Appeals
Coordinator
Blue Cross and Blue Shield Association
225 North Michigan Avenue
Chicago, Illinois 6060
Send a copy of Fiscal Intermediary and PRRB hearing requests to Cahaba at the address listed on the "Write Us" page under Provider Audit and Reimbursement/Financial.
Questions
If you have questions about an audit-related issue, contact the number listed under the Provider Audit and Reimbursement Contact Information on the “Phone Us” page.
Page last updated: June 18, 2008
