Mandatory self-service clerical error reopening requests
First Coast receives nearly 1.7 million clerical error reopenings (CERs) each year from Medicare Part B providers. To reduce mail volume and improve efficiency, CER requests for minor claim corrections will no longer be accepted by fax or mail, except in limited approved exceptions. Electronic submission of claim corrections eliminates mailing delays, protects patient information, allows for immediate confirmation of receipt, and expedites processing and payment timeframes. All CERs must be submitted through one of the free, electronic self-service tools - SPOT, the interactive voice response (IVR) system, or the Reopening Gateway. SPOT is the recommended method for submitting claim corrections.
Implementation
Clerical error reopening requests received via fax or mail will be returned unless they meet approved exception criteria.
| State(s) | Effective Date |
|---|---|
|
Florida Puerto Rico U.S. Virgin Islands |
October 1, 2026 |
Begin submitting all CERs electronically today using SPOT or our other self-service tools to ensure the fastest, most efficient processing.
Approved exceptions for fax or mail CERs
Fax or mail submissions will only be accepted for:
- Services requiring the review of medical documentation review
- Adding/changing/deleting certain modifiers (22, 23, 24, 51, 52, 53, 62, 66, 80, 81, EA, GA, GX, GY)
- Not other classified (NOC) or unlisted procedure codes
- Medicare secondary payer (MSP) data
- Changes to the quantity billed for anesthesia type of service (7)
If a claim does not meet one of these exceptions, CERs must be submitted through SPOT, the IVR, or the Reopening Gateway.
SPOT
SPOT provides an easy-to-use platform with multiple features. Providers who are not currently enrolled are encouraged to submit the SPOT enrollment form.
- Instructions for completing the EDI SPOT enrollment form for provider organizations
- Instructions for completing the EDI SPOT enrollment form for third-party organizations
Enrollment requires 1-2 weeks, and incorrect or incomplete information may extend processing time.
Providers already enrolled should begin using SPOT for all claim reopening and appeal requests.
Instructions for adding providers or establishing additional users are available on the SPOT account updates webpage.
SPOT resources
Reopening Gateway
The Reopening Gateway requires no enrollment and offers a fast, web-based option for submitting claim corrections, billed in error requests, and history updates. It is designed for use with the Medicare Remittance Advice (MRA), as it does not retrieve protected health information from Medicare systems. The Reopening Gateway provides a convenient way for providers, billing services, and clearing houses to correct and reprocess claims.
Reopening Gateway resources
IVR
The telephone based interactive voice response unit (IVR) requires no enrollment and provides a wide range of automated services using either voice commands or keypad input. The IVR claim correction feature supports unlimited CERs for select Medicare Part B claims, offering a fast and flexible option for submitting corrections.