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) 308-5441, Monday through Friday, anytime between 9 a.m. through 12 p.m. and 1 p.m. through 3 p.m. 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:
| Reason for Telephone Claim Correction |
CPT Modifiers:
21, 25, 26, 50, 51, 54, 57, 58, 59, 66, 73, 74, 76, 77, 78, 79, 80, 82 |
HCPCS Modifiers:
AA, AD, AT, E1, E2, E3, E4, G8, G9, GV, GW, LT, KD, QJ, QK, QR, QW, QX, QY, QZ, Q3, RT, TC |
Mathematical/computational mistakes with quantity billed field:
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. |
| Transposed procedure/diagnosis codes |
Incorrect duplicate denials:
Example: ambulance trip denied as duplicate, but there were two identical trips on the same day. |
| Incorrect provider identifier, use of a modifier or date of service (month and day only) |
| Misapplication of a fee schedule |
| Claim submission errors that will result in an overpayment. Palmetto GBA will initiate the overpayment process. |
Be sure to refer to the Denial Finder tool on our Web site for resources and tips on filing claims correctly the first time. Select 'Browse by Topic' on the left side of this Web page.