Last Modified: 4/3/2011
Location: FL, PR, USVI
Business: Part B
Duplicate claims
• If submitting paper claims, allow time for FCSO to receive, scan, and enter claims into the system. Claims should not be resubmitted before 45 days, to allow for complete processing.
• Allow at least 45 days from the date FCSO received the claim for a claim to finalize. If the claim has not finalized in 45 days and the IVR is not conveying status information, call Part B customer service’s toll-free line 1-866-454-9007 for additional assistance, before resubmitting the claim.
• If a clerical reopening has been requested, it may take up to 60 days to process and finalize the adjustment to the claim. Allow the reopening to finalize and do not resubmit claims during this time.
• If resubmitting claims to correct minor clerical errors or omissions, be sure to resubmit ONLY the denied service(s).
• Resubmitting an entire claim will create a duplicate denial.
• Ensure appropriate modifier(s) are on claim lines.
• Complete the free WBT titled Duplicate claims -- Part B available via the FCSO Medicare training website at www.fcsomedicaretraining.com
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• Access the replay of the Ask-the-contractor webcast Understanding and resolving duplicate claims -- Part B, available in the "Online resources", located in the "Library" of the FCSO Medicare training website at www.fcsomedicaretraining.com
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Source: FCSO Education Action Team