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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.

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

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

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