Providers may request a reopening of the original claims processing decision by contacting the Telephone Reopening Unit (TRU).

The TRU can be used when you wish to revise the initial determination or redetermination of a specific service or claim for minor clerical errors. If you have a general question or need to talk to someone about an issue that cannot be reopened, please contact our Customer Care Contact Center.

TRU representatives will reopen claims to correct minor, uncomplicated, provider or carrier clerical errors or omissions. However, TRU representatives cannot add items or services that were not previously billed. Please Note: Reopenings are granted at the contractor’s discretion; a claim may not be appealed if contractor decides not reopen the claim.

Effective May 19, 2008, the TRU no longer accepts faxed documents. Providers with multiple issues are encouraged to continue to call or write to National Government Services with their appeals requests.

Note: Unsolicited faxes will be returned to the sender unprocessed.

Contacting the Telephone Reopening Unit
TRU representatives are available Monday through Friday, 8:00 a.m. to 12:00 p.m., and 1:00 to 4:00 p.m. eastern time (ET), and can assist you with up to three claims per call.

What Information Should I Have Available When I Call?
Please be prepared to provide the following information when you call the TRU:

• Beneficiary’s name
• Medicare Health Insurance Claim number (HICN)
• Your full name (first and last name)
• Your phone number
• Provider’s name
• Item or service in question
• Date(s) of service in question
• Reason for request

When Should I Contact Customer Care
Questions concerning any of the topics listed below should be directed to the Customer Care Contact Center.

• General claims status
• Unprocessable/returned claims (this situation is identified as message MA-130 located on your provider remittance statement)
• Denial of payment based on entitlement, i.e., entitlement to the Medicare program or health maintenance organization coverage
• General inquiries that are not claim specific

Interactive Voice Response System
The following toll-free numbers will connect you with our Interactive Voice Response (IVR) system:

• Connecticut: 866-419-9455
• Indiana: 866-250-5665
• Kentucky: 866-290-4036
• New Jersey: 877-567-9235
• New York:
  • Queens county: 877-868-7965
  • Southern counties: 877-869-6504
  • Upstate counties: 877-567-7173