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Appeals

First-level appeals status
list item Find the outcome of first-level appeals on SPOT – Online access to first-level appeals outcomes, exclusively on SPOT.
News
Redeterminations for HCPCS G0463 paid under OPPS
Modified: 4/5/2021
Please review this article for information on redeterminations for HCPCS code G0463 when performed by hospital outpatient clinics for visits furnished in excepted off-campus provider-based departments of hospitals.
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When and how to appeal
list item When to file an appeal – Use this calculator to calculate time limits for filing requests for all five levels of appeals.
list item How to appeal a claim – Learn about the five levels of appeals and how to begin the appeals process.
Appeals forms
Locate the necessary forms to appeal claim decisions.
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FAQs
Find the answers to common appeals-related questions.
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more Important things to know about Part B appeals
Appeals contact information
Find phone numbers and addresses for appeals-related inquiries.
• Part B Florida
• Part B Puerto Rico
• Part B U.S. Virgin Islands
Overpayments
Did you receive a demand letter or notice an overpayment? Learn more with the following resources and forms:
more Overpayment request submission reminders
more FAQs -- learn more about how to handle overpayments
more Forms -- find the appropriate forms to resolve or dispute overpayments
Resources
more Appeals information on CMS.gov external link
more CMS appeals process flow chart external pdf file
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.
Part B