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Withdrawals

Home Withdrawals

The Code of Federal Regulations does not contemplate a Withdrawal of a Service Determination. It is notable however, that many organizations utilize this classification. Because these requests are often accompanied by documentation of participant declination of a service, it is typically mitigated during an audit. However, Organizations with numerous “Withdrawn” SDR’s tend to come under great scrutiny by audit teams. Multiple Withdrawn SDR’s implies participants may be receiving coaching to withdraw a request – this practice denies the participant their right to appeal and is thus considered egregious by CMS.

A more appropriate method in dealing with a scenario in which a participant wishes to withdraw a request is to process the SDR as a denial with the participant request to withdraw as the rationale for denial.

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