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Appeals Forms and Tools

CGS has created a variety of forms and tools which have been designed specifically to assist you with the Appeals process.

The easiest, fastest and most efficient way to correct or reopen a claim is to utilize the myCGS Web Portal. You can find the claim correction or claim reopening feature using the Reprocessing tab.

To help you with the appeal preparation process, CGS has also created checklists to walk you through both the Redetermination and the Reconsideration Appeals levels. Each checklist has a separate completion guide so you know you are collecting all the appropriate information needed to support your Level I or Level II appeal.

Remember, each level of appeal has specific timelines and requirements so use our CGS tools to ensure your Appeal is submitted correctly and timely.

Appeals Forms

Forms


Checklists


Guides/Instructions


Tools
ALJ Appeals Status RequestExternal Website

The Office of Medicare Hearings and Appeals (OMHA) has made a link available so you can check the status of your appeal hearing before the Administrative Law Judge (ALJ). Scroll to the bottom of the page and click on "PROCEED TO AASIS." You will be directed to the ALJ Appeal Status Information System Inquiry page. Enter the ALJ Appeal Number (e.g. 1-############), referenced on the Acknowledgement Letter or Notice of Hearing from the Office of Medicare Hearings and Appeals in the appropriate cell. Next, answer the security/validation question then click "Submit Inquiry." The resulting page will give you the status of the appeal in question. Please note, the system will allow you to enter up to ten (10) appeal numbers - follow the instructions on the page.

Appeals Decision Tree

Do you need to submit a request for redetermination or request a reopening? Use the Appeals Decision Tree for guidance on the correct action to take.

Appeals Time Limit Calculator

I would like to submit my Redetermination Request today. Will it meet the 120 day timeliness requirement?


Check Your ALJ Appeals Status Online!

The Office of Medicare Hearings and Appeals (OMHA) has made a link available so you can check the status of your appeal hearing before the Administrative Law Judge (ALJ). Click here to access the siteExternal Website. Scroll to the bottom of the page and click on "PROCEED TO AASIS." You will be directed to the ALJ Appeal Status Information System Inquiry page. Enter the ALJ Appeal Number (e.g. 1-############), referenced on the Acknowledgement Letter or Notice of Hearing from the Office of Medicare Hearings and Appeals in the appropriate cell. Next, answer the security/validation question then click "Submit Inquiry." The resulting page will give you the status of the appeal in question. Please note, the system will allow you to enter up to ten (10) appeal numbers - follow the instructions on the page.

CGS has created the Documentation Identification Tool to assist you in submitting the different types of documentation needed to support your claim.


Related Information

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