How would I appeal a Medical Necessity (CO-50) denial?
First fill out a Redetermination Request Form. You can find the form by accessing the Forms section of our website. Once the form is completed, you may send it and any documentation supporting payment for your claim to the following address: CIGNA Government Services DME MAC Jurisdiction C P.O. Box 20009 Nashville, TN 37202 You may also now fax redetermination requests. The fax number for a redetermination request is 1.615.782.4630. For more information regarding appeals, please refer to the DME MAC Jurisdiction C Supplier Manual, Chapter 13.
Related Questions
- What will DCS accept from the provider when supporting a medical necessity denial? If the provider has their own algorithm for medical necessity can this be used to support the decision?
- What are my possible next steps with a medical necessity denial (CO-50, remark code N115) based on a Local Coverage Determination (LCD)?
- What is the appeal process for denial of medical necessity by utilization review?
