myCGS

Appeals

Checking Redetermination Status

HHH, Part A, and Part B users may check the status of an appeal from the “Get Status” button.

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Enter the Submission ID assigned to the form for a general status. The status page will show the current status of the request in addition to the details submitted on the redetermination.

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Or, all users can click on the Submission ID located in the confirmation received in your Messages inbox. myCGS will display the same information as above.

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Part A and HHH Users

For Part A and HHH users, Appeals status is also displayed under the Claims tab in myCGS. To view the status of an appeal:

  • Access the claim information under the Claims tab.
  • The Claim Status Information page will display. Click on the claim number to view the claim details.

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The Detailed Claim Status Information page identifying the claim information will display an Appeals window. If a 1st level appeal, Redetermination, has been requested on the claim, you will see this window populate.

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In the Appeals window, you will see:

  • The level of appeal requested.
  • The status of the appeal and, if complete, the date the case was closed.
  • The appeal number assigned to the case.
  • Option to perform other functions, depending upon the appeal status and decision.

If the Redetermination is in a "Closed" status and the decision is Unfavorable, Partially-Favorable, or a dismissal, you may view the letter sent to you explaining our decision by clicking on the "View Decision Letter" link.

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The decision letter is a PDF of the letter you receive via Green Mail or hardcopy.

NOTE: A Fully-Favorable decision will not generate a letter. Please refer to your Remittance Advice to find the adjustment.

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