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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
J15 Part A Medical Review
PO Box 20021    
Nashville, TN 37202

FedEx/UPS/Overnight Courier:
CGS J15 Part A Medical Review
Two Vantage Way 
Nashville, TN 37228
   

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!

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