Medicare Reopening request- Second level appeal request

Second Level Appeal Request: 

Reopening If the reopening request is the result of medical review decision (N102 on your Remittance Advice-RA), please attach a copy of the RA and any supporting documentation. If you are unsure whether to request a redetermination or a reopening, request a redetermination as there are specific time limits for submitting redetermination requests.

You can request a Reopening from Palmetto GBA to reopen the claim and correct the following minor errors or omissions:
= Mathematical or computational mistakes 4 If you submitted the incorrect units (i.e., 1 instead of 2 in item 24G or its electronic equivalent), adjust the charge accordingly

= Transposed procedure or diagnostic codes

= Inaccurate data entry = Misapplication of a fee schedule

= Computer errors

= Duplicate denials - When you believe that the 'duplicate' denial is incorrect (e.g., ambulance trip denied as duplicate, but there were two identical trips on the same day)

= Incorrect data items such as a modifier or date of service (month and day only)

= Adjustments to claims that were submitted in error that will result in an overpayment. Palmetto GBA will initiate the overpayment process when you notify us that this situation has occurred.

Related Links :

• Medicare first level appeal

• Administrative law judge hearing third

• Reconsideration by QIC second level of appeal