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Last Modified: 3/22/2018 Location: FL, PR, USVI Business: Part A

Resubmission of denied claim FAQ

Q: Can we resubmit a claim that was denied by the recovery auditor (RA) if we determine the incorrect code was submitted?
A: No, you must submit a redetermination (the first level of the appeals process). There are edits in the fiscal intermediary shared system (FISS) that will prevent you from performing an adjustment against the denied claim or submitting a new claim for the same dates of service.
Source: The Centers for Medicare & Medicaid Services (CMS) internet-only manual (IOM) Pub. 100-04, Chapter 29 external pdf file
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