Other Appeals

I (or my representative) would like to appeal a Medicaid decision about a service (ie: therapy, pharmacy, nursing, personal aide, etc.).

Personal Information

 

You must exhaust the internal appeals process with your MCO before you can appeal to the Division of Appeals and Hearings.
Representative Information
(ie: parent, child, physician, etc.)
Documentation

Please state why or how you think the agency erred or why you are appealing.

If you would like to attach the denial notice, authorized representative form/notice of appearance, or supporting documentation, please do so now. You will have an opportunity to do so later after your appeal is received.

Files must be less than 32 MB.
Allowed file types: jpg jpeg png txt rtf pdf zip.
Files must be less than 32 MB.
Allowed file types: jpg jpeg png txt rtf pdf zip.
Accommodations

Do you or your representative require special accommodations?

 

Most hearings are held at the SCDHHS main office in downtown Columbia, where metered parking can be limited. Would you like us to reserve parking for you for purposes of the hearing?

The Division of Appeals and Hearings will make every effort to obtain and reserve parking for hearing participants. However, reserved parking is not guaranteed. You will be notified if we are unable to reserve parking for you.
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