Tips for providers submitting appeals for multiple beneficiaries as a single package using a roster or coversheet

First Coast Service Options Inc. (First Coast) has determined that some providers are submitting multiple re determination requests for multiple beneficiaries in a single package using a single roster or cover sheet. When this type of appeal request is received by First Coast’s mail room, it requires special handling to separate each appeal individually with the documentation. This could result in the individual case files not being reviewed with all of the documentation the provider intended.

To prevent this confusion, First Coast recommends that providers submit each appeal request with an appeal form for each beneficiary and that the documentation that follows for each be specific to that appeal. This will ensure that the documentation for each appeal remains intact. While a roster or a cover sheet is not necessary, it should only address the number of appeals in the package.

The appeals forms are available at http://medicare.fcso.com/Appeals/276199.asp.