Clerical reopening requests

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Home ► Appeals ► Clerical reopening requests

Last Modified: 6/21/2017 Location: FL, PR, USVI Business: Part B

Spotlight on success

“The SPOT is the way to go. No more filling out forms and then having to fax or mail them in. I have used SPOT to get several claims re-opened.”

-Kristin Gunn,

South Florida Revenue Cycle Specialists, LLC

Filing an appeal or need to reopen a claim? First Coast Service Options offers secure messaging and claim reopening through the SPOT. Find out how one Medicare billing expert uses the SPOT to correct claims online.

Clerical reopening requests

How to correct your claim

Minor errors or omissions may be corrected outside of the appeals process.

Part B clerical reopening requests may be submitted online through SPOT or via telephone through the interactive voice response (IVR) system.

Option 1: Submit reopenings online using SPOT

The SPOT offers registered users the time-saving advantage of correcting clerical errors in their eligible Part B claims quickly, easily, and securely -- online.

To begin, search for the claim you wish to correct by its ICN or by its date(s) of service in Claim Status. The SPOT will automatically determine if any line items are eligible and prepopulate the online request form accordingly.

FAQs

• What types of changes may I include in a claim reopening request? May I change more than one field on each line item? Can I add or remove line items?

• How do I access a claim I wish to reopen? How will I know if any of the line items associated with a claim are eligible?

• Are there any restrictions on modifiers or procedure codes when using SPOT to reopen a claim?

• When I try to edit a field (e.g., modifier, DOS), the SPOT won’t allow me to add a value, delete a value, or edit a value. How can I resolve this problem? Are there any other issues that may prevent the SPOT from accepting a new/replacement value for an edited field?

Support

• The SPOT online claim reopening tutorial flash file

• The SPOT User Guide pdf file

Don’t have a SPOT account? Learn how to register now.

Option 2: Submit reopenings on the telephone with the IVR

If you don’t have online access, you may submit your Part B clerical reopening request through First Coast’s IVR system. Although the IVR offers the same primary request types as the SPOT, the IVR offers the additional option of making history corrections to your claim.

To access your claim through the IVR, you must enter the billing provider’s information (i.e., NPI, PTAN, and TIN), the beneficiary’s information (i.e., name, date of birth, Medicare number), and the ICN of the claim you wish to correct.

If you would like to take advantage of First Coast’s telephone submission method for clerical reopening requests, please refer to Telephone reopening requests via the IVR.

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.