Part C standard organization-determination intake

Organize an initial Medicare Advantage benefit or payment request by requester role and channel. No code, patient identifier, clinical urgency decision or coverage determination.

No patient names, identifiers, diagnoses, clinical notes or request descriptions are entered here. Keep operational case materials in the secure plan/provider system.

Sources and scope

Official CMS source — How to Request an Organization Determination; standard requester roles and verbal/written channels · checked 2026-10-15

Structured checklist, saved progress and CSV export require active medical research access. Current access and price.

For an existing adverse determination, check the separate plan reconsideration reference.