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Appeals/Redeterminations

Providers and beneficiaries may appeal an initial claim determination when Medicare's decision is to deny or partially deny a claim. The left side Appeals menu provides access to information about the five levels in the Medicare appeals process. CGS also offers frequently asked questions, and self-service tools to help determine if an appeal request is appropriate and to ensure that your appeal is submitted timely. You can also access the CGS Redetermination form and learn about when and how to request a Reopening.

Level of Appeals

Level of Appeals

Timeliness Calculator

Timeliness Calculator

CMS Resources

CMS Resources

Which Form Do I Use?

Which Form Do I Use?

Forms

Forms

When to File Appeal

When to File Appeal

When Not to File Appeal

When Not to File Appeal

Denial Codes

Denial Codes

Job Aid/Manuals

Job Aid/Manuals

Reopenings

Reopenings

 

Updated: 06.09.17

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