July 16, 2024
Faxed Appeals
Providers, or organizations acting on a provider’s behalf, are submitting redetermination (first level appeal) requests to fax numbers assigned to other departments (e.g., Customer Service, Claims, Medical Review, etc.).
Please note: J15 Appeals does not accept faxed requests. As a result, if you fax a redetermination request, CGS will not process your appeal.
J15 Appeals will accept redetermination requests submitted via the following methods:
If you choose to submit your request via esMD or mail, please complete and submit the appropriate redetermination request form:
- Medicare Part A Jurisdiction 15 Redetermination Request Form
- Medicare HHH Jurisdiction 15 Redetermination Request Form
Additional information: