Sample notices of appeal are. found in FORMS (pages 13 and 14). Along with the notice of appeal, you will generally file these additional documents: a. pre-calendar statement, a copy of the order or judgment appealed from, any decisions. the order or judgment is based on, and an affidavit of service.
Accessing the Medicaid Interactive Web Portal. A secure logon to the Medicaid Interactive Web Portal is required to access the new attachment option. For new providers, Medicaid will send a letter containing a personal identification number (PIN) and other information on how providers can access the Portal.
What to expect throughout the conciliation conference process. After the Bureau of Conciliation and Mediation Services (BCMS) accepts a request for a conciliation conference, they will assign a CMS number and send you an acknowledgment letter in approximately 10 days from the date of the request. They will also contact the division that issued the notice and advise them that you filed a protest.