Search results
Filter by type
Line of business
Category
Filter by date
20 of 30 results
View these request types and tips for claim reopenings.
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
First Coast is receiving several appeals of cardiovascular stress test claims that now require dual diagnoses. Please review this article for details on avoiding unnecessary denials and appeals by submitting the claim correctly the first ti…
Welcome to the First Coast Claim Reopening Gateway Help Guide.
Find the appropriate forms to appeal claim decisions.
Avoid the appeals process by making minor claim corrections through a clerical reopening request for Part B claims.
View this new provider roadmap for guidance through the Medicare process.
Section 1869(b)(1)(E) of the Social Security Act (the Act), as amended by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), requires an annual reevaluation of the dollar amount in controvers
The claims value in dispute must meet the threshold for obtaining an administrative law judge (ALJ) hearing and a judicial review in federal district court. This is called the “amount in controversy.” The amount in controversy is recalculat…
An appeal is a new and independent review of an initial determination of a claim.