Last Modified: 3/31/2019
Location: FL, PR, USVI
Business: Part B
Certain browsers have issues with interactive PDF forms. It is recommended to download and save the PDF by right clicking on the link to the PDF. Once the document is saved, first open your PDF reader and then open the file from within your reader. Additional information may be found on Adobe Acrobat's help document
Providers, participating physicians, and other suppliers have the right to appeal claim decisions. Appeals must be submitted using the following forms:
First level: Request for redetermination of a Part B claim Second level: Reconsideration request form -- C2C Innovative Solutions Inc. Third level: Hearing by an administrative law judge Fourth level: Medicare Appeals Council
Did your claim have a clerical error or other minor discrepancy? Part B claims may be corrected outside of the appeals process.
Correct your claim online through the SPOT
-- SPOT offers registered users the time-saving advantage of not only viewing claim data online but also the option of correcting clerical errors in their eligible Part B claims quickly, easily, and securely -- online.
Correct your claim by writing in, using the first level of appeal (redetermination). Writing in allows you to supply additional information you feel is necessary to correct a claim.
First Coast Service Options (First Coast) 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.