Original Medicare claim appeals
Turn Medicare denials into complete, on-time redeterminations.
Champ reads remittance advice, prepares the CMS-20027 or equivalent request, gathers the approved supporting record, submits to the correct Medicare Administrative Contractor, and tracks the decision through posting.
Medicare appeal queue
Every denial, record request, and outcome
Denial intake
Claim and remittance reason classified
Supporting record
Required documents collected and checked
MAC submission
Redetermination filed with confirmation
Decision posting
Outcome matched to the claim record
EXECUTION
Continuous
EVIDENCE
Every step
OWNER
Champ
120 days
filing window tracked
One packet
with supporting evidence
MAC-aware
submission and follow-up
The operational bottleneck
The form is standard. The evidence behind a successful appeal is not.
A redetermination request has a defined structure and filing window, but denial-specific documentation, medical-necessity support, coding context, and MAC submission paths still create high-touch work.
Bring us your workflowRemittance advice must be translated into the correct appeal or reopening path
Supporting evidence may span the EHR, orders, notes, delivery records, and billing system
Medicare Administrative Contractors maintain different portals and operational instructions
Clinical and coding judgment must remain with qualified reviewers
The production workflow
One continuous operation, not another disconnected tool.
Champ coordinates browser, document, API, voice, and human steps around the outcome your team is responsible for.
- 01Triage the determination
Read the remittance, identify the service and denial reason, calculate the deadline, and route minor corrections away from appeals.
- 02Build the supporting record
Retrieve the approved documentation checklist, collect the available records, and identify missing or inconsistent evidence.
- 03Prepare and submit
Populate the CMS-20027 or equivalent request, attach the reviewed evidence, submit through the correct MAC channel, and capture proof.
- 04Post and advance the outcome
Monitor the decision, update the claim and recovery record, and prepare the next approved action when further review is warranted.
Why it stays reliable
Built around the work, not a brittle integration map.
Your systems can stay exactly where they are. Champ operates across them, records what happened, and improves the workflow as the process changes.
Works with your stack
If your team can access it, Champ can work in it.
Use APIs where they are dependable and managed browser agents everywhere else. No rip-and-replace required.
Change the operating model
Give your team exceptions, not another queue to babysit.
- Staff interpret each remittance and search for the right next action
- Records are requested and assembled across multiple departments
- MAC portals and confirmations are tracked outside the claim system
- Decisions wait to be posted and routed for the next appeal level
- Denials enter an approved appeal, correction, or review path
- Documentation checklists drive collection and completeness review
- Submission and confirmation remain attached to the appeal case
- The decision updates the claim and triggers the next approved action
More healthcare workflows
One platform across the back office.
Original Medicare claim appeals FAQ
Questions healthcare operators ask first.
You have more questions?
Send us an email