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Last Modified: 12/10/2010
Location: FL, PR, USVI
Business: Part B
CO B7
Provider was not certified/eligible to be paid for this procedure/service on this date service
(THIS PHYSICIAN/SUPPLIER IS NOT ELIGIBLE TO RECEIVE PAYMENT)
Resources/tips for avoiding this denial
Services were denied because the date of service(s) on the claim is prior to the effective date or after the termination date of the Medicare enrollment of the billing provider who appears on the claim.
• Ensure to submit only claims for services during which the provider had active Medicare billing privileges.
• If services were provided prior to or after a provider's Medicare billing privileges were active, this denial will be received.
Tips to correct the denied claim
Verify the correct date of service(s) appears on your Medicare Remittance Advice (RA).
• If the date of service(s) on the RA is not correct, the procedures for correcting claims errors should be followed.
• Clerical error reopening requests to correct the date of service can be performed. View information on clerical error reopenings here on the First Coast Service Options (FCSO) Medicare provider Web site.
• If the date of service(s) is correct, there may be an issue with the effective or termination date of the provider’s Medicare billing number.
• View enrollment information through the Internet-based Provider Enrollment, Chain and Ownership System (PECOS). Click here 
for more details.
for more details.• If the enrollment issue is resolved, you can request a redetermination of your claim. Select the correct form for your region below:
Please use your browser's back button to return to the referring page. Source: FCSO Education Action Team
