Provider Appeals

Provider Information
Representative Information
Beneficiary Information


You must exhaust the internal appeals process with your MCO before you can appeal to the Office of Appeals and Hearings.

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. The notice is required at this time, but you will have an opportunity to submit additional documentation after your appeal is received.

Please save Microsoft Word documents as .PDF
Files must be less than 8 MB.
Allowed file types: jpg jpeg png txt pdf zip.
Please save Microsoft Word documents as .PDF
Files must be less than 8 MB.
Allowed file types: jpg jpeg txt rtf pdf zip.

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 Office 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.
Electronic Communications

You can receive all documents from the Eligibility Appeals Coordinators and Office of Appeals electronically. If you choose to receive communication electronically, the Office of Appeals or Eligibility Appeals Coordinators will send you a written confirmation. We will also send a test message to your email address and ask you to confirm you received it.

Please note: If you elect to receive communication electronically, we will email the message or document to you and it is presumed to have been delivered to you if it does not bounce back to us. If a message bounces back, we will resend it one more time. If the second attempt bounces back, we will place a copy of the correspondence or document in the mail to you.

I would like to receive all communications and documents from the Office of Appeals and the Eligibility Appeals Coordinators electronically.
I understand that all communication and documents will come to me via the email address I provide and will be presumed delivered if it does not bounce back.




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