Clerical reopening requests
How to correct your claim
Minor errors or omissions may be corrected outside of the appeals process.
Part A
Part A clerical reopening requests may be submitted using the Part A redetermination and clerical reopening request form. Submission options and additional information may be found on the Part A appeals forms page.
Part B
Part B clerical reopening requests may be submitted online through SPOT, the reopening gateway, or via telephone through the interactive voice response (IVR) system.
Option 1: Submit reopenings online using SPOT
The SPOT offers registered users the time-saving advantage of correcting clerical errors in their eligible Part B claims quickly, easily, and securely -- online.
To begin, search for the claim you wish to correct by its ICN or by its date(s) of service in Claim Status. The SPOT will automatically determine if any line items are eligible and prepopulate the online request form accordingly.
Support
- Learn about restrictions on modifiers or procedure codes for reopenings
- The SPOT User Guide: Section 6
Don’t have a SPOT account? Learn how to register now.
Option 2: Submit Part B reopenings through the reopening gateway
The Claim Reopening Gateway is an interactive tool that requires no registration or enrollment, and offers a quick and easy way to make Part B claim corrections directly on the First Coast website. For instructions on how to use the reopening gateway, view the help guide. Providers are encouraged to have the claim remittance advice readily available for proper utilization of the gateway.
Option 3: Submit reopenings on the telephone with the IVR
If you don’t have online access, you may submit your Part B clerical reopening request through First Coast’s IVR system. Although the IVR offers the same primary request types as the SPOT, the IVR offers the additional option of making history corrections to your claim.
To access your claim through the IVR, you must enter the billing provider’s information (i.e., NPI, PTAN, and TIN), the beneficiary’s information (i.e., name, date of birth, Medicare number), and the ICN of the claim you wish to correct.
If you would like to take advantage of First Coast’s telephone submission method for clerical reopening requests, please refer to telephone reopening requests via the IVR.