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