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First Coast Service Options Inc.
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Last Modified: 7/8/2011 Location: FL, PR, USVI Business: Part A

Common working file (CWF) rejects inquiry

Do you have questions concerning your claim that denied because information on the claim does not match the CWF beneficiary information (e.g., discharge status, name mismatch, female patient with a male procedure claim)?
There are a few steps you can take to verify this information.
• Utilize the Part A interactive voice response (IVR) system pdf file
• Use ELGA (eligibility A) in Direct data entry (DDE) pdf file.
• Check your claim to verify that it was coded correctly.
If your claim rejected with any of the following reason codes, click the code for specifics related to correcting or verifying this information:
• 10415
• 10420
• C7010
• C7109
• C7113
Note: There may be times when it is necessary to contact customer service in order to update information within the fiscal intermediary standard system (FISS) and allow your claim to continue processing. Before calling customer service, please have the following information available:
• Claim information including the health insurance claim (HIC) number, dates of service, and your national provider identifier (NPI).
• The correct beneficiary information.
Once you have this information, you will be able to adjust the claim and resubmit for processing.
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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.