Chapter VII: Online Reports View Submenu (04)

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About the 702 ACS Appeals Received Report

Description:

The Automated Correspondence System (ACS) master record inputs into the system so that this daily report can be created to allow providers to view which appeals were received by National Government Services. These entries will be available for 90 days before they are removed from the FISS DDE system.

Report Purpose:

The purpose is to provide a listing of appeals for the providers so they can verify that their redetermination request(s) were received and will also indicate if any appeals need to be resubmitted.

The following two screen prints show how the ACS APPEALS RECEIVED section appears on the FISS DDE online system:

Summary of ACS Appeals Received – Left View

Summary of ACS Appeals Received – Right View

The following chart describes the various fields/report headings contained within the ACS Appeals Received report.

Field/Report Heading	Description
PROVIDER	Provider number obtained from ACS master record.
HIC	Healthcare Identification Claim number obtained from the ACS master record
DCN	Document control number obtained from the ACS master record
TOB	Type of bill obtained from the claim record
STMT FROM	Statement from date obtained from the claim record
STMT THRU	Statement thru date obtained from the claim record
CATEG	Category obtained from ACS master record (Value A = Appeal)
TYPE	ACS category type from ACS master record
RECEIPT DATE	Date of appeal receipt obtained from ACS master record.

Revised 6/23/2017