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Appeals

Avoid the wait, submit electronically
Quick clicks
list item When to file an appeal – Use this calculator to calculate time limits for filing requests for all five levels of appeals.
list item How to appeal a claim – Learn about the five levels of appeals and how to begin the appeals process.
list item Submit your appeal and view status through SPOT – Submit redeterminations (level one appeals) electronically using the SPOT portal.
list item Confirmation of appeal requests – use this tool for confirmation that appeal requests have been received by First Coast.
Modified: 5/17/2024
The appeals department is receiving appeals regarding the incorrect usage of modifiers associated with PET scans. Read this article to learn more about billing these services correctly.
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Locate the necessary forms to appeal claim decisions.
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Find the answers to common appeals-related questions.
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Find phone numbers and addresses for appeals-related inquiries.
Overpayments
Did you receive a demand letter or notice an overpayment? Learn more with the following resources and forms:
more FAQs -- learn more about how to handle overpayments
more Forms -- find the appropriate forms to resolve or dispute overpayments
Redetermination survey
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Part B