Appeals
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…
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.
Cardiology: Avoid denials and appeals -- new dual diagnosis requirements for cardiovascular stress test procedures
First Coast is receiving several appeals of cardiovascular stress test claims that now require dual diagnoses. Please review this article for details on avoiding unnecessary denials and appeals by…
Cardiology: Avoid denials and appeals -- new dual diagnosis requirements for cardiovascular stress test procedures
First Coast is receiving several appeals of cardiovascular stress test claims that now require dual diagnoses. Please review this article for details on avoiding unnecessary denials and appeals by…
Part A claim reopenings beyond timely filing limit process changes
Learn how to request a reopening of your Part A claim that is past the 12-month timely filing provision.
Advance payment – Part B only
View this article for information about Part B advance payment submissions.