Allowing electronic submission of medically denied cancel claims, reason code 30941

Previously, First Coast did not allow the submission of electronic claim cancellations with medically denied items and services. Effective immediately, First Coast will allow electronic submissions of cancel claims with denied items and services. To ensure appropriate processing of your claim, please provide detailed remarks indicating the reason why the claim cancellation is necessary.

For example, if you are submitting a claim cancellation due to an outpatient claim (013X type of bill) overlapping with an inpatient claim (011X type of bill) during the three-day payment window, add the remarks “Overlapping an inpatient claim” so the claim can be processed without manual intervention. All other remarks may cause the claim to suspend for claims processing manual intervention.

Please keep in mind that there are certain scenarios in which hardcopy claim submissions (including adjustments and cancels) may be necessary. These include, but are not limited to:

• Claim cancel requests where Medicare is listed as the secondary or tertiary insurer. Also known as Medicare secondary payer (MSP) claim.