View/Submit Redetermination (First Level Appeal)

If you are a beneficiary-debtor or insurer-debtor, or are a verified authorized representative, and you have received a demand letter, you have the right to appeal the determination if you disagree that you owe money, as explained in the demand letter, or if you disagree with the amount that you owe. A redetermination request provides a second chance to have someone other than the original reviewer examine the original demand, along with any supporting documentation that you submit with the redetermination request.

Clicking the View/Submit Redetermination (First Level Appeal) action allows you to submit a redetermination request (first level appeal) on the MSPRP. After a redetermination request is submitted on the MSPRP, you can click this action to submit further redetermination requests or view redetermination status information for the case including the Redetermination Received Date, Redetermination Decision, and the Redetermination Decision Date.

Who Can Submit a Redetermination?

• Beneficiary-debtor cases: The beneficiary or beneficiary representative with a verified POR
• Insurer-debtor cases: The insurer or insurer representative with verified Recovery Agent Authorization

Who Can View a Redetermination?

• Beneficiary-debtor cases: The beneficiary or beneficiary representative with a verified POR
• Insurer-debtor cases: The insurer or insurer representative with verified Recovery Agent Authorization, or the beneficiary or beneficiary representative with verified POR
• Beneficiary- or insurer-debtor cases: A beneficiary representative with a verified CTR

Other Requirements to Submit a Redetermination Request?

• The case must be in a Demand Issued status and a demand letter has been sent for the case (as determined by the Demand Letter Mail Date).
• Redetermination requests must be submitted within 120 days from the date of receipt of the demand letter.
• Users may submit only one request per claim or claim line.

Other Requirements to View a Redetermination Request?

• At least one redetermination request must have been previously submitted on the MSPRP or by mail.