Check Appeal Status

Table of Contents

• Check Appeal Status
• Check Status of Requests Submitted in NGSConnex
• Check Status of Requests Not Submitted in NGSConnex

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Check Appeal Status

1. Click the Appeals button from the NGSConnex homepage.

2. In the Select a Provider panel, click the Select button next to the applicable provider account.

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Check Status of Requests Submitted in NGSConnex

1. To check the status of a redetermination, reopening or reconsideration submitted via NGSConnex, select the Appeal History button.
   
   
    
2. If the 'Appeal Number' column does not display 'Pending,' you can select the blue claim number hyperlink in the 'Claim Number' to view the appeal status information.
   
   
    
3. Select ‘Appeal Status’ from the left-side navigation. If appeal status information is available for the claim selected the following information will display. If appeal status information is not available, a ‘No items to show’ message will display.
   
   

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Check Status of Requests Not Submitted in NGSConnex

1. To check the status of a redetermination, reopening or reconsideration not submitted via NGSConnex, select the Claim Search button.
   

You can use the filter options to locate the claim you would like to check appeal status for.

• Medicare Number – you can search by entering either the Social Security based HICN or MBI
• Claim Number
• From Service Date and To Service Date

The following information will be provided:

• Claim Number – click the claim number hyperlink to view additional claim details for a specific claim.
• Medicare Number – click the Medicare number hyperlink to view the Medicare beneficiary’s name.
• From Service Date
• To Service Date
• Claim Status
• Total Charges

2. Select the Claim Number hyperlink to view Appeal Status information.

3. Select Appeal Status from the left-side navigation.
4. If appeal status information is available, the following information will display.
   • Appeal Number
   • Received Date
   • Status
   • Decision Date
   • Adjustment DCN
   • Appeal Level
   • View Decision Letter – a link to view the appeal decision letter

If appeal status information is not available a message will display.

Revised 9/13/2024