Suspended -- status of pending claim inquiry PUS

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Suspended -- status of pending claim inquiry PUS

Last Modified: 8/5/2011 Location: FL, PR, USVI Business: Part A

Suspended -- status of pending claim inquiry

If your claim has been suspended or if you need to know the status of a pending claim, use the resources below to help you find the information you need:

• There are several ways you can access information on the status of a claim:

• Utilize the interactive voice response (IVR) system

• Use Direct data entry (DDE)

. Select option 1-Inquiry Menu and then select option 12-Claims Status. Next, enter the claim number and dates of service. Click enter, and the status of your claim will be displayed.”

• If you receive an additional development request (ADR) asking for medical records, please respond promptly.

• Until the requested information has been received, the claim status will not change.

• Once documentation has been received and reviewed, your claim will be properly adjudicated.

If your claim is pending in a status that you are unable to verify, contact provider customer service at 1-888-664-4112.

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Source: FCSO Education Action Team

First Coast Service Options (FCSO) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.