Process an Appeal

When a client requests an appeal the process does not change with CCMS. The Bureau of Administrative Hearings (BAH) receives the Appeal Request from a client and mails a request confirmation letter to the client. BAH sends the confirmation letter and hearing schedule to BCCD and the corresponding CCR&R/Site.

The CCR&R/Site attempts to resolve the appeal through the Pre-Appeal process. If resolved, the client may choose to withdraw the appeal. If not resolved, the CCR&R/Site completes the Statement of Facts.

The hearing is conducted and a final decision is reached. If the appeal decision is affirmed, BCCD monitors the implementation of the appeal decision and completes the implementation of appeal form once the CCR&R/Site has implemented the decision.

CCMS is used to track the status of an appeal and to notify BCCD and the CCR&R/Site of the status and actions that must be taken.

  • Refer to the Create a Work Item, and Create a Case Note, Create a Provider Note, and Create a Work Item Note wizards to assist you in processing the appeal.

The following steps are performed by BCCD:

The Bureau of Administrative Hearings (BAH) receives the IL444-0103 - Notice of Appeal form from client and mails an appeal request confirmation letter with the date of the scheduled hearing to the client, BCCD and CCR&R/Site.

  • BCCD will create an Appeal Work Item in CCMS to associate the IL444-0103 - Notice of Appeal.

Create an Appeal Work Item - Process Steps:

  1. Navigate to the Work Item Search page to conduct a search and confirm the desired Work Item does not exist in CCMS.
  2. Click [Create New] at the bottom of the Work Item Search page.
  3. The Work Item Details page displays
  4. Scroll to the Work Item Details section of the page.
  5. Select Appeal from the Work Item Type drop-down list.
  6. Select the correct Source from the drop-down list.
    • Fax
    • Scan
    • Email
    • Mail
    • Phone
    • Other
    • No Contact
  7. Select the correct CCR&R/Site agency from the Assigned Org drop-down list.
  8. Do not complete the Assigned Team or Assigned Worker fields. CCMS will automatically route this Work Item to the correct team for processing according to routing rules.
  9. Select Appeal Created in the Work Flow Status drop-down list.
  10. The Work Item Status will default to new when creating a new Work Item.
  11. Select a case or provider to associate with the appeal.
    • Next to the Provider # and Case # field there is an icon. Click on the icon to access a search page to search for the correct case or provider to associate to the Work Item.
  12. Scroll to the Reported By section of the page.
  13. Document information on the person who requested the Appeal, including First Name, Last Name, Phone Number, and Email.
    • Notice there is an Overpayment Information section to the page. This section is only required for Overpayment Work Items and can be ignored when creating an Appeal Work Item.
  14. Scroll to the Other section of the page.
  15. Complete the Receive Date field.
  16. Optional: In the Due Date field, type a due date for the response in the following format: MM/DD/YYYY.
  17. Type information regarding the appeal in the Description field. This field has a 500 character limit.
  18. Click [Save].
    • Clicking [Save] triggers the following task "Appeal Created" to agency in the Assigned Org field alerting them an Appeal Work Item has been created.
  19. Scan the IL444-0103 - Notice of Appeal and trip sheet into CCMS, and associate with the correct client or provider on the Validate Documents page.

The following steps are performed by the CCR&R/Site:

  1. Receive the Appeal Created Task.
  2. Review the Work Item Details page to learn information about the appeal.
  3. Select the correct worker in the Assigned Worker field.
  4. Click [Save]. When you save the Work Item Details page, the Work Item Status field automatically changes to In Progress because a worker is assigned.
  5. (Outside of CCMS) Perform the Pre-Appeal process with the client.
  6. If the client chooses not to withdraw the appeal, generate the Statement of Fact form using the Document Links page.
  7. Complete the Statement of Fact form and add the form to CCMS using scan, fax, email, or the Upload Documents page.
    • Best Practice! After completing the Statement of Facts, it is a best practice to record a Work Item Note to add any necessary additional information.
  8. Navigate to the Work Item Details page, and change the Work Flow Status field to Appeal updated.
  9. Select BCCD from the Assigned Org drop-down list.
  10. Do not complete the Assigned Team or Assigned Worker fields. CCMS will automatically route this Work Item to the correct team for processing according to routing rules.
  11. Click [Save].
    • Clicking [Save] triggers an "Appeal updated" task to agency in the Assigned Org field (BCCD).

The following steps are performed by the BCCD:

  1. Receive the Appeal Updated task.
  2. Send the completed Statement of Fact form to the client and BAH.
  3. (Outside of CCMS) BAH conducts the hearing and issues a sends the final decision form to BCCD.
  4. BCCD receives the final decision form and adds to CCMS using scan, fax, email, or the Upload Documents page.

If the Appeal is dismissed, the following steps are taken:

  1. BCCD: Navigate to the Work Item Details page, and change the Work Flow Status field to Appeal dismissed.
  2. Select the correct CCR&R/Site agency from the Assigned Org drop-down list.
  3. Do not complete the Assigned Team or Assigned Worker fields. CCMS will automatically route this Work Item to the correct team for processing according to routing rules.
  4. Click [Save].
    • If the client fails to appear for the appeal, client has the opportunity to request that the appeal be reopened. If BAH reopens the appeal, the closed Appeal Work Item may be reopened or a new Appeal Work Item is created.
    • Clicking [Save] triggers an "Appeal dismissed" task to agency in the Assigned Org field.
  5. CCR&R/Site: Receive the task and navigate to the Work Item Details page to review the appeal information.
  6. Select Complete in the Work Item Status field to close the Work Item.
  7. Click [Save].

If the Appeal is affirmed, the following steps are taken:

  1. BCCD: Navigate to the Work Item Details page, and change the Work Flow Status field to Appeal affirmed.
    • Clicking [Save] triggers an "Appeal affirmed" task to agency in the Assigned Org field.
  2. BCCD: Contact the CCR&R/Site about appeal implementation outside of CCMS.
  3. BCCD: After the appeal decision is implemented, generate IL444-1456 Implementation of Appeal Decision using the Documents Links page.
  4. BCCD: Complete the IL444-1456 Implementation of Appeal Decision form and mail to BAH.
  5. BCCD: Add the completed IL444-1456 Implementation of Appeal Decision to CCMS using scan, fax, email, or the Upload Documents page.
  6. BCCD: Select Complete in the Work Item Status field to close the Work Item.
  7. Click [Save].

If the Appeal is not affirmed, the following steps are taken:

  1. BCCD: Navigate to the Work Item Details page, and change the Work Flow Status field to Appeal updated.
  2. BCCD: Contact the CCR&R/Site about appeal implementation outside of CCMS.
  3. CCR&R/Site: updates the case to comply with BAH hearing decision
  4. BCCD: After the appeal decision is implemented, generate IL444-1456 Implementation of Appeal Decision using the Documents Links page.
  5. BCCD: Complete the IL444-1456 Implementation of Appeal Decision form and mail to BAH.
  6. BCCD: Add the completed IL444-1456 Implementation of Appeal Decision to CCMS using scan, fax, email, or the Upload Documents page.
  7. BCCD: Select the correct CCR&R/Site agency from the Assigned Org drop-down list.
  8. Do not complete the Assigned Team or Assigned Worker fields. CCMS will automatically route this Work Item to the correct team for processing according to routing rules.
  9. BCCD: Select Complete in the Work Item Status field to close the Work Item.
  10. Click [Save].

If the Appeal is withdrawn, the following steps are taken:

  1. Client notifies CCR&R/Site they wish to withdraw the appeal.
  2. CCR&R/Site: Generate an IL444-0065 - Request to Withdraw Appeal form using the Document Links page.
  3. CCR&R/Site: After the IL444-0065 - Request to Withdraw Appeal form is returned by the client; add the document into CCMS using scan, fax email, or the Upload Documents page.
  4. CCR&R/Site: Navigate to the Work Item Details page, and change the Work Flow Status field to Appeal withdrawn.
  5. CCR&R/Site: Select BCCD from the Assigned Org drop-down list.
  6. Do not complete the Assigned Team or Assigned Worker fields. CCMS will automatically route this Work Item to the correct team for processing according to routing rules.
  7. Click [Save].
    • Clicking [Save] triggers an "Appeal withdrawn" task to agency in the Assigned Org field (BCCD Appeals Coordinator).
  8. BCCD: Receive the task and navigate to the Work Item Details page to review the appeal information.
  9. Select Complete in the Work Item Status field to close the Work Item.
  10. Click [Save].

Appeal: Work Flow Status Key

The agency in the Assigned Org field is the organization that owns the Work Item and receives the task. CCMS will send the task to the correct team according to that agency's routing rules.

Work Flow Status When do I select? Related Task
Appeal Affirmed After BCCD receives the IL444-1456 Implementation of Appeal Decision form affirming the appeal from BAH and adds the form into CCMS Appeal affirmed
Appeal Created After BCCD receives the IL444-0103 - Notice of Appeal form and adds the form into CCMS. Appeal created
Appeal Dismissed After BCCD receives the appeal dismissal form from BAH and scans it into CCMS. Appeal dismissed
Appeal Updated

After an update is made to the appeal. Appeal Updated is used when an Appeal is not affirmed.

*This can be used at any time a Work Item is updated (Example: A new document is added).

 Appeal updated
Appeal Withdrawn After CCR&R/Site or BCCD receives the IL444-0065 - Request to Withdraw Appeal form from the client and adds it into CCMS. Appeal withdrawn