December 12, 2016
Denial Message - 56900 (Non-Receipt of Records)
Once again CGS is seeing a large volume of Medical Review Reopening requests being submitted to the Appeals department in error.
- This action delays the correct processing of your claims.
- Claims that originally denied for missing the 45-day records submission deadline do not usually need a determination letter from Appeals.
Follow these important tips:
- If it’s still within 120 days of the remittance advice date and you want to submit the records, send the records to Medical Review and ask for a Reopening at:
CGS |
FedEx/UPS/Overnight Courier: |
Fax: 803.462.2596 |
- If Medical Review denies the claim and you disagree with the determination, a Redetermination (appeal) is your next step.
- If it has been more than 120 days from the remittance advice date, submit the records to Appeals with a complete and concise Redetermination Request (preferably via the myCGS portal). Click here to learn more about the myCGS portal. Uploading documents is easier than ever!