- ABN Modifiers
- American Medical Association and Current Procedural Terminology
- CMS Forms and Publications
- CMS Regional Offices
- Clinical Lab Improvement Amendment
- Comprehensive Error Rate Testing
- Electronic Health Records
- Electronic Prescribing
- Evaluation and Management Documentation Guidelines
- Federal Register
- Health Insurance Portability and Accountability Act of 1996
- Interactive Voice Response System
- Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
- Local Coverage Determination
- Medically Unlikely Edits
- Medicare Coverage Database
- Medicare Electronic Data Interchange
- Medicare Fraud and Abuse
- Medicare Learning Network®
- Medicare Provider-Supplier Enrollment with NGS
- NGS Internet Resources
- NGSConnex Online Web Application Can Save Time and Money
- NGS Check Provider Enrollment Application Status Tool
- National Correct Coding Initiative
- National Coverage Determination
- National ICD-10-CM-PCS: The Next Generation of Coding
- National Provider Calls and Events
- National Provider Identifier
- National Provider Identifier Registry
- National Uniform Claim Committee
- Open Door Forums
- P.O. Box Mailing Addresses
- Patient Protection and Affordable Care Act of 2010
- Physician Quality Payment Program
- Provider Contact Center
- Provider Enrollment
- Reconsideration (Second Level of Appeal)
- Recovery Audit Program
- Redetermination (First Level of Appeal)
- Skilled Nursing Facility Consolidated Billing
- U.S. Government Printing Office
- Washington Publishing Company
Redetermination (First Level of Appeal)
A redetermination is an examination of a claim by NGS personnel who are different from the personnel who made the initial claim determination. The appellant (the provider filing the appeal) has 120 days from the date of receipt of the initial claim determination to file an appeal.
A redetermination may be requested in writing via the NGS Part B Redetermination First Level Appeal Form or via our NGSConnex portal. It is recommended to submit redeterminations via our NGSConnex, because electronics is a faster way to receive your reimbursements. If you are not a member of our NGSConnex, we recommend that you register today!
The minimum monetary threshold is not required to request a redetermination.
If mailing the Redetermination, please mail form to:
J6 mailing address:
National Government Services, Inc.
P.O. Box 6475
Indianapolis, IN 46206-6475
JK mailing address:
National Government Services, Inc.
P.O. Box 7111
Indianapolis, IN 46207-7111
Visit Request a Redetermination for additional information.
Reviewed 10/13/2023