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Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
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Last Modified: 7/3/2020 Location: FL, PR, USVI Business: Part A

Adjusting a denied claim FAQ

Q. Can I adjust a claim that has been denied, which is in a 'D' status location in direct data entry pdf file (DDE)?
A. No. If a claim has been denied, the provider cannot submit an adjustment. Any attempted adjustments will reject with a reason code stating the claim cannot be adjusted.
A denial could result from edits in the fiscal intermediary shared system (FISS) or through a medical review.
Please follow the guidelines for the Appeals process to submit a redetermination request.
Source: Provider Outreach and Education (POE) and Electronic Data Interchange (EDI)
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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.