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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. 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.

Which Form Do I Use?

Which Form Do I Use?

What should I submit with my appeal?

What Should I Submit with My Appeal?

Timeliness Calculator

Timeliness Calculator

Level of Appeals

Level of Appeals

When to File Appeal

When to File an Appeal

When Not to File Appeal

When Not to File an Appeal

340b Appeals

340b Appeals

Denial Codes

Denial Codes

Reopenings

Reopenings

Forms

Forms

Job Aid/Manuals

Job Aid/Manuals

CMS Resources

CMS Resources

Updated: 06.17.19

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