The Centers for Medicare and Medicaid Services (CMS) has provided an appeals process to physicians who wish to contest their meaningful use incentive payment. You may apply for this appeal if you were unable to receive the meaningful use payment or if you had your incentive payment revoked due to an audit or other issue.
The form requires physicians to provide their contact information, reason for the appeal, and supporting documentation. Submit your completed form to email@example.com.
Download the appeal request form.