Because we, VIVA MEDICARE, denied your request for coverage of (or payment for) a prescription drug, you
have the right to ask us for redetermination (appeal) of our decision. You have 60 days from the date
of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. Please
provide as much information as possible to submit your appeal online. If preferred, you may also submit
your request by mail or fax.
Address:
VIVA MEDICARE
Pharmacy Department
417 20th Street North
Suite 1100
Birmingham AL 35203
Fax Number:
205-449-2465
Who May Make a Request:
Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative. Contact us to learn how to name a representative.