SPOT features and functionality

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Home ► SPOT News ► SPOT features and functionality

Last Modified: 4/14/2022 Location: FL, PR, USVI Business: Part A, Part B

SPOT features and functionality	Part A	Part B
Appeal request via claim status Check the status of a claim as well as submit level 1 (redeterminations) and level 2 (reconsiderations) appeal requests	X
Appeal status Obtain information regarding status of appeals, including the outcome of the appeal	X	X
Appeals outcome Obtain the outcome of appeal decisions by viewing copies of the redetermination notices	X	X
AR transaction details Obtain account receivable details including recoupment, adjustment, collection amounts, and duplicate demand letters	X	X
Claim reopening request Submit a request for a reopening to be performed	X	X
Claim status Obtain the status of a claim that is accepted into the claim processing system	X	X
Comparative billing report (CR) Obtain reports, which provide insight into billing trends, and assist providers with self-audits of procedures and billing practices		X
EDI form request Request an update to the EDI enrollment information	X	X
Eligibility Check patient eligibility and obtain benefit details	X	X
MBI lookup tool Look up patient Medicare beneficiary identifier (MBI) numbers	X	X
Medical review claims View additional documentation request (ADR) status and dates, copies of ADR letters, and status and outcome of the review	X	X
Medical review records submission Submit requested medical review records in response to ADR letters	X	X
MSP overpayment form Submit a request for an MSP overpayment to be performed		X
Non-MSP overpayment form Submit a request for a non-MSP overpayment to be performed		X
Overpayment correction Report a duplicate claim, services not rendered, or other correction on a single line or full claim.		X
Overpayment letters View, save, or print copies of overpayment letters	X	X
Payment status Obtain check information such as check number, amount, dates, and check status.	X	X
Prior authorization request submissions Part A and B: • Hospital outpatient department (OPD) services Part B only: • Submit prior authorization requests for Part B repetitive non-emergent ambulance transportation	X	X
Retrieve remittance advice copies View, save, or print copies of the remittance like the standard paper remittance (SPR)	X	X
Submit 1099 forms Submit request for 1099 copies, corrections or to dispute the information	X	X
Submit appeal requests Submit appeal requests with documentation	X	X
Submit general information requests Submit general inquiries such as questions related to coverage guidelines, policy issues, or how to bill Medicare	X	X
Submit Provider Audit & Reimbursement documents Submit documentation to Provider Audit & Reimbursement including supplemental security income (SSI) realignment requests, wage index/occupational mix submissions, cost report reopening requests, and more	X

For instructions on using these features once enrolled for SPOT, access the links below:

The SPOT: User Guide

Part A appeals submission and status

Part B appeals submission and status

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