The Reopening Gateway is a free self-service tool that does not require enrollment! This tool is a web-based application that allows the automated submission of claim corrections, billed in error requests and history corrections.
Logging into the Reopening Gateway is a quick and easy way to update claim data through the internet.
The application is designed to be used in conjunction with the Medicare Remittance Advice (MRA), since protected health information will not be retrieved and displayed from the Medicare processing systems. If a clerical error or billing error is identified upon receipt of the MRA, the Reopening Gateway offers a convenient solution to providers, billing services and clearinghouses to correct and reprocess claims.
Log in to submit your claim corrections today!
Claim Corrections:
The following claim corrections are permitted through the Reopening Gateway:
Referring Provider National Provider Identifier
Referring Provider Name (first letter of their first name, first four letters of their last name)
From and To Date of Service
Diagnosis Codes
Place of Service
Procedure Code
Quantity Billed (Units) Note: Listed under “NOS” under the MRA for Number of Services
Billed Amount
Modifiers can be added, changed or deleted
Billed in Error:
Report an entire claim or individual lines of a claim as billed in error.
The claim must be fully or partially paid and have no Medicare Secondary Payer information in order to use this feature.
History Corrections:
This option allows you to resubmit a claim without making any corrections. This option is only valid for the following scenarios:
The beneficiary’s record has been corrected to indSW
icate Medicare is now primary for the date(s) of service of the denied claim.
The beneficiary’s record has been corrected to indicate the beneficiary is entitled to Medicare Part B for the date(s) of service of the denied claim.
The beneficiary’s record has been corrected to indicate the beneficiary’s Hospice election period no longer conflicts with the date(s) of service of the denied claim.
The beneficiary’s record has been corrected to indicate the beneficiary is no longer covered by a Medicare Advantage Plan for the date(s) of service on the denied claim.
Medically Unlikely Edits (MUE) denials involving two claims that were submitted at the same time; resulting in a MUE denial along with a duplicate claim denial.
For additional information, see the Reopening Gateway User Manual in the "References" section below.
To access the tool, you will provide your email address, to which we will instantly send a one-time passcode - a randomly generated six-digit code acting as your One-Time Provider Identification Number. This code will give you immediate access to the Reopening Gateway.
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