Initiate a Clerical Error Reopening

Table of Contents

• Initiate a Clerical Error Reopening
• Reopening Details
• Claim Lines
• Attachments
• Submit

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Initiate a Clerical Error Reopening

1. Select the Appeals button on the home page.

2. In the Select a Provider panel, click the Select button next to the applicable provider account.

3. Select Claim Search to search for the claim you are appealing.
4. Enter any of the following search criteria in the filters fields.
   • Medicare Number
   • Claim Number
   • From Service Date
   • To Service Date
5. Select the Search button.
6. Click the checkbox next to the claim you are appealing.
7. Select the Initiate Clerical Error Reopening button.

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Reopening Details

1. Complete the required Reopening Details fields.
   • Requester’s Full Name
   • Requester’s Phone
   • I do not agree with the claim determination for the following reasons.
   • Additional information Medicare should consider.
2. Make claim header changes to any of the following, if applicable:
   • Diagnosis 1-8
   • Patient Discharge Status
3. Select the ‘Next’ button.

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Claim Lines

1. Locate the claim line(s) you would like to reopen, and then click the ellipsis to the left of the line you want to reopen
2. Select Edit Line.

3. You can make changes to any of the following fields for each claim line.
   • Service Date
   • Revenue Code
   • Procedure Code
   • Modifier 1 or 2
   • Total Units
   • Total Charges
4. Once all changes are completed for the claim line, select Save. You can makes changes to multiple lines by following these steps.

5. After all applicable claim line(s) have been edited, select the Next button.

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Attachments

1. In the Attachments section you will upload all supporting documentation you would like to submit with your request. You have the option to drag and drop and attachment or browse your computer for an attachment.
2. We will accept most common file formats. There are no limits on the number of attachments you may include with your response. It is recommended that you limit the size of each attachment to 25 MB or less. The Attachment Name should be comprised of letters and numbers. If an Attachment Name contains any special characters you must rename the attachment.
3. Select the Next button.

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Submit

1. Once you have verified your Reopening request is complete and you have attached all supporting documentation, select the Submit button to transmit your request to National Government Services.

2. The following message will display indicating the reopening request was successfully submitted.
3. An email verification will be sent to the email address associated with the user profile, acknowledging receipt of the reopening request.