Docs / Working cases

Resubmissions & appeals

A non-affirmation isn’t the end — most documentation-driven denials are winnable on resubmission once the gap is closed.

Setting up the second round

Create the follow-up as a case with submission type: Resubmission (or Appeal), and record the prior UTN from the original decision — the MAC uses it to link your new request to the first one, and AffirmDME’s checklist enforces its presence on any non-initial submission so it can’t be forgotten.

Closing the gap first

Before resubmitting, use the original case’s checklist and decision reason to target exactly what failed: pull the missing records via prescriber outreach, get the order signed if signature was the issue, and confirm the checklist reads green before the second submission — the whole point is not repeating round one.

Decisions and analytics

Record the second decision like any other. Structured decision reasons across rounds are what make your dashboard’s denial analytics actionable — you’ll see which documentation gaps actually cost you money.