Last Modified: 10/6/2022
Location: FL, PR, USVI
Business: Part A
SPOT offers providers a convenient way to submit appeal requests – specifically level-one and level-two appeals – also called redeterminations and reconsiderations.
These types of appeals are separate from reopenings, which occur outside of the appeals process, and are how providers correct minor errors or omissions on their claims. (Note: Reopenings can also be done via SPOT; view information here
Part A: Submit redeterminations and reconsiderations
Part A providers can easily submit redeterminations and reconsiderations via SPOT.
• First, access the claim details by selecting Appeal Requests / Outcome from the Appeals submenu.
• Note: for claims processed more than 12 months ago, select Redetermination Request from the Appeals submenu to be directed to the redetermination form.
• Use the Claim Status and Appeals Requests query form to conduct a search
• Once results appear, choose the claim from the resulting list, and click on the applicable claim number to view the available appeal options
• To submit a level-one appeal (redetermination), click on the Submit an Appeal button
• Complete the form, upload supporting documentation, and click Submit
To submit a level-two appeal (reconsideration):
• Click on the L2 request link from the claim status page
• Complete the fields on the Claim Reconsideration form, load supporting documentation, and click Submit
• Access the claim details by selecting Appeal Requests / Outcome from the Appeals submenu.
• Use the Claim status and appeals requests query form to conduct a search
• Note: For appeals submitted on claims processed more than 12 months ago, select Appeals Outcome from the Appeals submenu to be directed to the appeals outcome search.
• On the results screen, click on the applicable claim number to view appeals information
• Details include appeals status, outcome, and the ability to view decision letters
Part A possible outcomes:
• Partially favorable
View the SPOT User Guide
for more details on submitting appeals and all of SPOT’s features and functions.
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.