Appeals
Changes to amount in controversy (AIC) for appeals in 2026
The claims value in dispute must meet the threshold for obtaining an administrative law judge (ALJ) hearing and a judicial review in federal district court. This is called the “amount in controversy…
Appeal status requests must be obtained through SPOT
To enhance efficiency and ensure the secure handling of appeal information, all providers will be required to use SPOT to check appeal status and access duplicate appeal decision letters, effective…
New provider roadmap: Appeals
An appeal is a new and independent review of an initial determination of a claim.
New provider roadmap: Appeals
An appeal is a new and independent review of an initial determination of a claim.
Overpayment request submission reminders
Submitting complete information for an overpayment request is important for accurate processing. This article provides reminders for submitting overpayment requests to First Coast.
Overpayment request submission reminders
Submitting complete information for an overpayment request is important for accurate processing. This article provides reminders for submitting overpayment requests to First Coast.
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…
Before you appeal a claim or request a redetermination
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.