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Appeals

Electronic Health Record (EHR) Incentive Program Appeals 

If you have been denied an EHR incentive payment, have been determined to be ineligible for the program, or have received an audit decision that you believe to be in error, you can appeal the decision. Medicare eligible professionals (EPs) should file appeals with CMS, while Medicaid eligible professionals should contact their State Medicaid Agency for information about filing an appeal. Medicare eligible hospitals and critical access hospitals (CAHs) should also file appeals with CMS, whereas Medicaid eligible hospitals or any hospital that wants to appeal its Medicaid eligibility should contact their State Medicaid Agency for information about filing an appeal. Because CMS will conduct audits for both Medicare and Medicaid eligible hospitals, all appeals of eligible hospital audits should be filed with CMS.

In order to begin the appeals process EPs, hospitals, or CAHs must complete the appropriate filing request below.  It is important to follow the instructions specific to your appeal type on the filing request.  Please note that the appeals submission process is time sensitive with a 30 day window for submission period.  The filing request and supporting documentation must be submitted electronically to ehrappeals@provider-resources.com. The appeal will only be processed if all documentation is provided at the time of submission.  For further information regarding audit and appeals documentation go to educational resources and scroll down to the Audit Information and Guidance section.

To formally file a Medicare EHR Incentive Program appeal*:

*Hand written applications may delay processing.

EPs

Hospitals/CAHs

All correspondence regarding appeals should be sent to ehrappeals@provider-resources.com.