Redeterminations Status Update & Frequently Asked Questions
Why are the Customer Service Representatives (CSRs) unable to tell me whether my redetermination request has been received?
The internal method used by WPS Medicare to process redetermination requests may be a change from the method used by your outgoing contractor. Our process is as follows:
Each redetermination request is immediately assigned a tracking number upon receipt in the WPS mailroom. The tracking number includes the date of the receipt. The specific details of the request, such as the provider number, date of service, and patient's Medicare number, are not entered into the Multi-Carrier System (MCS) until a member of the Appeals staff works the request. Therefore, CSRs (and reopening staff) are unable to confirm receipt of redetermination requests prior to the time the case is worked.
Please note: If you have questions regarding a redetermination decision, please call Customer Service.
What date are the requests currently being worked?
We do have some inventory that is aged more than 60 days. At this time, you can expect the redetermination requests to be processed within 90 to 100 days. We request that providers wait at least 110 days from the date of the initial determination before resubmitting a second redetermination.
Page Last Updated: Friday, 07-Nov-2008 12:56:49 CST
