Appeals
New Part A Medicare redetermination and clerical error reopening request form available now
Make sure to access our new and improved form which simplifies the submission of your Part A redeterminations.
New Part B Medicare redetermination and clerical error reopening request form
Make sure to access our new and improved form to submit for your Part B redeterminations.
Appealing new patient denials
Learn how to submit an appeal for evaluation and management services denials because the new patient did not meet new patient qualifications.
Limitation of recoupment process (Medicare Modernization Act [MMA] 935)
Read this article to learn more about the 935 recoupment process.
Appeal tips: Documentation to include with your Part B redetermination request
Learn what documentation to include when submitting a Medicare Part B appeals request.
Limitation of recoupment process (Medicare Modernization Act [MMA] 935)
Read this article to learn more about the 935 recoupment process.
Avoid claim denials: Bill drug wastage correctly using the JW modifier
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for drug wastage not reported. Read to learn more about Medicare coverage guidance so you can document…
Save valuable time: Avoid having to file an appeal for HBO services
First Coast wants you to prevent claim denials or unfavorable redetermination appeal decisions for hyperbaric oxygen therapy (HBO) services. Read to learn more about Medicare coverage guidance so you…
Good cause for extension of the time limit for filing appeals
The time limit for filing a request for redetermination may be extended in certain situations. Good cause may be found when the record clearly shows, or the provider, physician or other supplier…
Appeals status lookup tool: Part A help guide
This help document guides you through using the appeals status lookup tool on First Coast's Medicare provider website.