myCGS

Medical Review

Post-Pay Review

Your MR Dashboard also allows you access to claims reviewed on a post-pay basis. To view, select the Post Pay Review Cases sub-tab.

Screenshot
A list of claims reviewed on a post-pay basis will display. If there are claims pending because we sent an ADR letter asking for additional information, a "Submit Documents" button will be available in the "Actions" column. Clicking the button will allow you access to the ADR Response Form. You may attach documentation directly to the form and submit the requested information to us.

Also, like the Medical Review Claims sub-tab, depending upon the status of the post-pay review, you will be able to complete other functions including asking questions and requesting a Redetermination or a Part B Reopening. When one of these options is selected, that form will open and auto-populate with information specific to the provider, claim, and the patient. Refer to sections above for additional information on other functions.

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