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CMS Pub. 100-06, ch. 6, § 380

Exhibits

activein force · 2026-08-25 – presentas-observed

B3-13416

Exhibit 1 - Medicare Program - Carrier Appeal Report - Form CMS-2590

MEDICARE PROGRAM - CARRIER APPEAL REPORT - FORM CMS-2590

CARRIER ID ___________________ REPORT PERIOD _____________________

A. CARRIER APPEAL REQUESTS

TOTAL

REVIEWS

(1)

TELEPHONE

REVIEWS

(2)

HEARINGS

(3)

1. OPENING PENDING

2. ADJSTMTS TO PNDNG

3. ADJUSTED PENDING

4. REQUESTS RECEIVED

4A. MED. DOC. DENIALS

5. REQUESTS TRANSFERRED

6. REQUESTS CLEARED

7. NO. OF CLAIMS

8. AMT IN CONTROVERSY

9. AFFIRMATIONS

10. DISMISSED/WITHDRAWN

11. REVERSALS

12. AMOUNT AWARDED

FORM CMS-2590 SCREEN 1

Exhibit 2 - Medicare Program - Carrier Appeals Report - Form CMS-2590

MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS-2590

CARRIER ID __________________ REPORT PERIOD _____________________

REVIEW

REQUESTS

REVIEWS

(1)

HEARING

REQUESTS

HEARINGS

(2)

PROCESSING TIMES PROCESSING TIMES

13. REVIEWS- AVERAGE 23. HEARINGS- AVERAGE

14. NBR COMP 1-30 DYS 24. NBR COMP 1-60 DYS

15. NBR COMP 31-45

DYS

25. NBR COMP 61-90 DYS

16. NBR COMP 46-60

DYS

26. NBR COMP 91-120

DYS

17. NBR COMP 60 DYS+ 27. NBR COMP 120 DYS+

PENDING TIMES PENDING TIMES

18. CLOSING PENDING 28. CLOSING PENDING

19. NBR COMP 1-30 DYS 29. NBR COMP 1-60 DYS

20. NBR COMP 31-45

DYS

30. NBR COMP 61-90 DYS

21. NBR COMP 46-60

DYS

31. NBR COMP 91-120

DYS

22. NBR COMP 60 DYS+ 32. NBR COMP 120 DYS+

HEARING RESULTS

OTR

WITH NO

SUBSEQUENT

HEARING

(1)

TELEPHONE

(2)

IN-PERSON

(3)

NBR IN

120 DYS

(4)

33. REVERSALS

34. AFFIRMATIONS

35. TOTAL DECISIONS

36. NBR IN 120 DYS

37. NO PREV OTR HELD

38. PREV OTR COUNTED

39. PREV OTR NOT

COUNTED

FORM CMS-2590 SCREEN 2

Exhibit 3 - Medicare Program - Carrier Appeals Report - Form CMS 2590

MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS 2590

CARRIER ID ___________________ REPORT PERIOD _____________________

B. PART B ALJ HEARINGS

TOTAL

(1)

DISPOSITIONS

(2)

B. PART B ALJ

HEARINGS

TOTAL

(1)

40 OPENING PENDING 55. WAIVED -

BEN & PROV

41 ADJUSTMENTS TO

PENDING

56. AMOUNT

AWARDED

42. ADJUSTED OPENING

PENDING

57. CLOSING

PENDING

43. REQUESTS RECEIVED 58. EFFECT.

OF ALJ DEC

44. REQ. FORWARDED TO

ALJ

59. NO. 1-7

DAYS

45. NO. OF CLAIMS

INVOLVED

60. NO. 8-15

DAYS

46. NO. IN 1-7 CALNDR

DAYS

61. NO. 16-30

DAYS

47. NO. IN 1-14 CLNDR

DAYS

62. NO. OVER

30 DAYS

48. AVG TIME TO

FORWARD

49. COMPLETED

50. AMOUNT IN

CONTROVERSY

51. AFFIRMATIONS

52.

DISMISSALS/WITHDRAW

ALS

53. REVERSALS

(FULL/PART)

54. AMOUNT AWARDED

FORM CMS-2590 SCREEN 3

Exhibit 4 - Medicare Program - Carrier Appeals Report - Form CMS-2590

MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS-2590

CARRIER ID ___________________ REPORT PERIOD ____________________

C. REOPENINGS (CLAIM COUNTS

TOTAL

(1)

PRE-REVIEW

(2)

POST-REVIEW

(3)

POST-HEARING

(4)

63. TOTAL

64. UNFAVORABLE TO

CLAIMANT

65. NO CHANGE

66. FAVORABLE TO CLAIMANT

67. AMOUNT AWARDED

D. LIMITATION OF LIABILITY

(CLAIM COUNTS)

INITIAL

CLAIM

(1)

REVIEW

(2)

HEARING

(3)

ASSIGNED CASES

68. TOTAL NUMBER

CONSIDERED

69. CONSIDERED - NOT

WAIVED

70. WAIVED-BEN. ONLY

71. WAIVED-BEN.& PROV

72. AMT AWARDED

UNASSIGNED CASES

73. TOTAL NUMBER

CONSIDERED

74. PHYS REFUND WAIVED

75. PHYS REFUND UPHELD

FORM CMS-2590 SCREEN 4

History

(Rev. 6, 08-30-02)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c27f8d9c93af3c5d27ead01fd6770e5cd1f4a46c6e2a8b4f15a7c2ab76eaa328
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