- Tip Sheet for Medicare Providers on First Level of Appeals (Redeterminations)
- Tip Sheet for Medicare Providers on First Level of Appeals (Redeterminations)
- Tip Sheet for Medicare Providers on First Level of Appeals (Redeterminations)
- About Appeals
- About Appeals
- About Appeals
- Reopening versus Redetermination
- Who May File an Appeal
- Who May File an Appeal
- Who May File an Appeal?
- Who May File an Appeal?
- Levels of Appeals and Time Limits for Filing
- What Documents are Needed
- What Documents are Needed
- MSP Overpayments
- Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials
- What Documents are Needed
- Submit an Appeal Electronically with NGSConnex
- Submit an Appeal Electronically via esMD
- Initiate Part B Reopenings or Non-MSP Overpayment Adjustments in NGSConnex
- Submit an Appeal Electronically via esMD
- What Documents are Needed
- Submit an Appeal Electronically via esMD
- Get Help Submitting an Appeal Hard Copy
- Get Help Submitting an Appeal Hard Copy
- Get Help Submitting an Appeal Hard Copy
- Submit an Appeal Electronically with NGSConnex
- Submit an Appeal Electronically via esMD
- Get Help Submitting a Appeal Hard Copy
- How to Prevent Duplicate Appeal and Clerical Error Reopening Requests in NGSConnex
- How to Avoid Costly Appeals
Submit an Appeal Electronically with NGSConnex
Table of Contents
- Submit an Appeal Electronically with NGSConnex
- Step 1: Access NGSConnex
- Step 2: Submit an Electronic Appeal and Attach Documentation
- Step 3: Attach Documentation
Submit an Appeal Electronically with NGSConnex
Only redetermination or reopening requests may be submitted electronically. To determine if your appeal qualifies as a reopening or redetermination, access the About Appeals page. All other appeals must be submitted by mail to the appropriate Medicare contractor. For information on other types of appeals, check our Levels of Appeals and Time Limits for Filing web page.
Step 1: Access NGSConnex
Login to NGSConnex with your username and password. Access our NGSConnex marketing page for details about obtaining a username and password.
Step 2: Submit an Electronic Appeal and Attach Documentation
Follow the step-by-step instructions in the NGSConnex User Guide to submit the appeal.
Step 3: Attach Documentation
If additional supporting documentation needs to be included, follow the instructions to add the documentation. Any documentation submitted previously to the NGS Medical Review Department, or to another Medicare contractor, for example the Recovery Auditor does not need to be resubmitted. There are no file size limitations for the attachments that can be submitted in NGSConnex. The only file types not accepted are, .xml, .log, and .cfg. For assistance in determining what type of documentation should be submitted, please access "What Documents are Needed".
Please share your thoughts about your experience with our redetermination process.
Revised 4/17/2023
Helpful Resources
Log Into NGSConnex
Appeals Timeline Calculator
YouTube Video: Holistic Approach to Avoiding Administrative Burden
Form(s) you'll need: