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Last Modified: 2/10/2018 Location: FL, PR, USVI Business: Part B

Claim Reopening: Check status FAQ

Q: How do I know if my claim reopening request was successfully submitted? What will happen if my request has been approved? May I check the status of my request?
A: Although Part A SPOT users may submit claim reopening requests through SPOT’s Secure Mail system, Part B SPOT users may submit claim reopening requests directly to the appeals system by using SPOT’s Claim Reopening feature.

How to determine if a claim reopening request was submitted successfully

If your claim reopening request was submitted through SPOT successfully:
SPOT will display a confirmation page with your confirmation number
You will receive a confirmation email from TheSPOTPortal.

How to know if your request has been approved or denied

If your request to reopen the claim has been approved, you will receive a new remittance advice notification, which will list the adjusted claim amount and the new ICN for the adjusted claim.
Note: The ICN of the adjusted claim will be different from the ICN of the original claim.
If your request to reopen the claim was not approved, you will receive a letter or telephone call notifying you of the decision.

How to check the status of a Part B claim reopening request

To check on the status of your Part B claim reopening request, you may call the IVR (1-877-847-4992) and follow these steps:
Indicate your location:
For providers in Florida or U.S. Virgin Islands – press 1
For providers in Puerto Rico – press 2
Indicate you wish to use touchtone – press any key
Note: Providers in Florida have the option of selecting speech or touchtone when using the IVR.
Select Check status information -- press 2
Select Correspondence and appeal status -- press 2
When prompted, use the telephone keypad to enter the required information: NPI, PTAN, TIN, and the ICN of the original claim. If you need to enter any letters, use the touchtone converter.
The interactive voice response system (IVR) will give you the status of your claim reopening request.
For more information on using First Coast’s IVR, please review the Part B IVR operating guide – Florida and U.S. Virgin Islands or Part B IVR operating guide – Puerto Rico.

How to check the status of a Part A claim reopening request

Part A SPOT users may submit claim reopening requests through SPOT’s Secure Mail, which transfers the electronic form and any associated documentation to First Coast’s e-documentation system. For more information on secure messaging, please review the Secure Mail FAQ.
To check on the status of a Part A claim reopening request, you may use the Check Status submenu option of Secure Mail.
Note: Part A providers may also check the direct data entry (DDE) system. For more information on this topic, please review the Medicare Part A DDE user manual pdf file
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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.