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Appeals news

Modified: 5/17/2024
The appeals department is receiving appeals regarding the incorrect usage of modifiers associated with PET scans. Read this article to learn more about billing these services correctly.
Modified: 4/16/2024
Learn what documentation to include when submitting a Medicare Part B appeals request.
Modified: 4/3/2024
Learn how to submit an appeal for evaluation and management services denials because the new patient did not meet new patient qualifications.
Modified: 3/14/2024
Make sure to access our new and improved form to submit for your Part B redeterminations.
Modified: 3/7/2024
Review our tutorial and learn how to correctly complete this form to ensure more accurate processing.
Modified: 10/25/2024
First Coast offers multiple ways of appealing a claim denial. The most efficient way to do so is through First Coast’s portal, SPOT.
Modified: 10/25/2024
Modified: 10/16/2024
View this article for information about Part B advance payment submissions.
Modified: 7/6/2024
Make sure to access our new and improved form which simplifies the submission of your Part A redeterminations.
Modified: 5/18/2024
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for hyperbaric oxygen therapy (HBO) services. Read to learn more about Medicare coverage guidance so you can document and submit HBO services correctly.
Modified: 5/6/2024
We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.
Modified: 4/24/2024
Claims that are returned as unprocessable cannot be appealed. So what do you do with them? An unprocessable claim is one that is filed with incomplete and/or invalid information. This article provides resources for you to diagnose unprocessable claims and resubmit them with correct information to get them paid.
Modified: 4/22/2024
Learn what documentation to include when submitting a Medicare Part A appeals request.
Modified: 4/17/2024
Review our tutorial and learn how to correctly complete this form to ensure more accurate processing.
Modified: 4/17/2024
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for drug wastage not reported. Read to learn more about Medicare coverage guidance so you can document and submit claims for drugs and reporting wastage correctly.
Modified: 4/17/2024
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for inpatient SNF services.
Modified: 4/16/2024
The time limit for filing a request for redetermination may be extended in certain situations. Good cause may be found when the record clearly shows, or the provider, physician or other supplier alleges and the record does not negate, that the delay in filing was due to one of the covered reasons.
Modified: 4/16/2024
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
Modified: 4/5/2024
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part B appeals and claim corrections.
Modified: 3/21/2024
Find the appropriate forms to report or dispute an overpayment.
Modified: 3/1/2024
Find the appropriate forms and submission details to appeal claim decisions.
Modified: 3/1/2024
Find the appropriate forms and submission details to appeal claim decisions.
Modified: 3/1/2024
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part A appeals and claim corrections.
Modified: 2/21/2024
Read this article to learn more about the 935 recoupment process.
Modified: 2/16/2024
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part A financial documentation requests.
Modified: 2/16/2024
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part B financial documentation requests.
Modified: 2/8/2024
Avoid the appeals process by making minor claim corrections through a clerical reopening request for Part B claims.
Modified: 6/7/2022
Use this tool for confirmation that appeal requests have been received by First Coast Service Options
Modified: 5/2/2022
Find information regarding the appeals process -- levels, forms, training, FAQs, and how to appeal Medicare coverage and payment decisions.
Modified: 5/8/2021
Find appeals related contact information.
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.