Appeals
Update of the 2025 dollar amount in controversy required to sustain appeal rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review
Section 1869(b)(1)(E) of the Social Security Act (the Act), as amended by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), requires an annual…
How to appeal a claim
First Coast offers multiple ways of appealing a claim denial. The most efficient way to do so is through First Coast’s portal, SPOT.
Tutorial: Completing the Medicare Part A redetermination and clerical error reopening request form
Review our tutorial and learn how to correctly complete this form to ensure more accurate processing.
How to appeal a claim
First Coast offers multiple ways of appealing a claim denial. The most efficient way to do so is through First Coast’s portal, SPOT.
How to complete the Medicare reconsideration request form (CMS-20033)
Find the appropriate forms to appeal claim decisions.
How to complete the Medicare reconsideration request form (CMS-20033)
Find the appropriate forms to appeal claim decisions.
What you should do with claims returned as unprocessable
Claims that are returned as unprocessable cannot be appealed. So what do you do with them? An unprocessable claim is one that is filed with incomplete and/or invalid information. This article…
Submit Part A appeals and claim corrections electronically
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options…