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September 28, 2017 - Updated: 11.23.21

Appeal Requests for Providers/Suppliers Affected by a Natural Disaster

In accordance with IOM 100-4, Chapter 29, 240.3, CGS may find good cause for an untimely appeal due to unavoidable circumstances such as major floods, fires, tornados, and other natural catastrophes. When filing an appeal with CGS the following information is required:

  • Beneficiary's name
  • Beneficiary's Medicare Identifier (HICN/MBI)
  • HCPCS codes for the specific item(s) being appealed
  • Specific dates of service
  • Printed name of the appellant or representative
  • Signature of the appellant or representative
  • Reason for the appeal
    • If you were affected by a natural disaster and are unable to file a timely appeal, please include the following information in your appeal request: "Extension requested due to natural disaster exception and include the name of the natural disaster."

For any other questions related to good cause for late filing, please contact 866-590-6727 for Jurisdiction B or 866-270-4909 for Jurisdiction C.

Medicare beneficiaries can call 1-800-MEDICARE (1-800-633-4227) for any questions.

Natural Disaster Information Links

Appeals Information Links


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