Do you need assistance to correct a simple error made on a claim? Please see the checklist below with the type of issues that can be corrected by telephone instead of filing a Redetermination (1st level of appeal).
Please contact us at (866) 669-5543, Monday through Friday, any time between 7 a.m. and 3 p.m. PST. Be prepared to provide the provider's identifier and the patient's Medicare number, last name and first initial. We can handle three qualified requests per call.
Remember: Rejected claims (remark code MA130) must be resubmitted as new claims and cannot be corrected by telephone.
You may request a telephone claim correction for any issues identified below:
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CPT Modifiers
21, 25, 26, 50, 51, 54, 57, 58, 59, 66, 73, 74, 76, 77, 78, 79, 80, 82
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HCPCS Modifiers
AA, AD, AT, E1, E2, E3, E4, G8, G9, GV, GW, LT, KD, KX, QJ, QK, QR, QW, QX, QY, QZ, Q3, RT, SG, TC
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Mathematical/computational mistakes with quantity billed field:
Note: If you submitted incorrect units (e.g., 1 instead of 2 in item 24G or its electronic equivalent), be sure to adjust the charge accordingly.
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Transposed procedure/diagnosis codes
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Incorrect duplicate denials:
Example: ambulance trip denied as duplicate, but there were two identical trips on the same day.
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Incorrect provider identifier, use of a modifier or date of service (month and day only)
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Misapplication of a fee schedule
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Claim submission errors that will result in an overpayment. Palmetto GBA will initiate the overpayment process.
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Be sure to refer to the Denial Finder tool on our Web site for resources and tips on filing claims correctly the first time. Web site addresses:
Jurisdiction 1 Part B:
www.PalmettoGBA.com/J1B