Last Modified: 12/5/2019
Location: FL, PR, USVI
Business: Part B
Q: Can I resubmit or adjust a claim when an appeal is processing?
A: It is not recommended to submit a new or adjusted claim when the appeal is pending.
Resubmitting or adjusting the claim does not reduce the processing timeframe for the appeal. In fact, it may result in an appeal dismissal or delay the processing time for the outstanding appeal. This matter affects appeals at various levels.
Adjustments to the initial claim or claim resubmission for the same service on the same date of service do not
extend the appeal rights on the initial determination. Click here
for information on when to file an appeal for each of the five levels.
Source: Centers for Medicare & Medicaid Services (CMS) internet-only manual (IOM) 100-04, Chapter 29
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Source: First Coast Education Action Team
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