Reopening Request Checklist

Before requesting a Reopening, use the below checklist to determine if a Reopening is the correct choice.

Yes/No Requestor Action
 
  • Do you have a Noridian DME Standard Paper Remittance (SPR) or Medicare Electronic Remittance Advice (ERA) for the claim(s) in question?
    • If not, submit request to Durable Medical Equipment Medicare Administrative Contractor (DME MAC) identified on ERA or SPR
 
  • Was the claim(s) in question denied as unprocessable?
    • If so, correct and resubmit new claim(s)

Note: Unprocessable claims with Remittance Advice (RA) message MA130 cannot be reopened. ("Your claim contains incomplete and/or invalid information, and no appeal or Reopening rights are afforded because the claim is unprocessable. Submit a new claim with the complete/correct information.")

 
  • Is the claim denial due to a minor clerical error or omission (e.g., units of service, service dates, HCPCS coding, diagnosis codes, etc.)?
    • If so, a Reopening request is appropriate. Select a method below.
 
 

 

Last Updated Jun 25, 2018