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December 11, 2018

myCGS Medical Review Reopenings

From your MR Dashboard, if you submit a request for Redetermination when viewing an Additional Documentation Request/Additional Development Request (ADR), there are occasions when the request is processed as a Medical Review (MR) Reopening. An example of when this may occur is when the time period to respond to an ADR has passed. If the documentation is received within a specific time frame, we may reopen the case and process the MR ADR.

You will know that an MR Reopening was performed by a banner that will appear in the header of the Detailed Claim Status Information page.

Screenshot

You will also notice the MR Reopening claim number listed on your MR Dashboard showing MR REOPEN as the ADR Status.

Screenshot

Take advantage of this enhancement and a number of additional myCGS functions available to you.

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