Appeals
New provider roadmap: Appeals
An appeal is a new and independent review of an initial determination of a claim.
What you should do with claims returned as unprocessable
Claims that are returned as unprocessable cannot be appealed. So what do you do with them? An unprocessable claim is one that is filed with incomplete and/or invalid information. This article…
Appeal reminder for medically unlikely edits (MUEs)
We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.
Before you appeal a claim or request a redetermination
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
Before you appeal a claim or request a redetermination
Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.
Appeal tips: Documentation to include with your Part A redetermination request
Learn what documentation to include when submitting a Medicare Part A appeals request.
Appeals status lookup tool: Part B help guide
This help document guides you through using the appeals status lookup tool on First Coast's Medicare provider website.
Claims and appeals for CPT 93010 performed in emergency room setting
Please review this article regarding appeals received for CPT 93010 (electrocardiogram report) and the use of modifier 77.