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State of CaliforniaHealth and Human Services AgencyDepartment of Health Care Services
MICHELLE BASS
DIRECTORGAVIN NEWSOM
GOVERNORPROVIDER NAME
ADDRESS 1
ADDRESS 2
CITY, STATE ZIP September 29, 2022,
NPI
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How to fill out resubmission of erroneously denied
How to fill out resubmission of erroneously denied
01
Carefully review the reason for the denial of the submission.
02
Correct any errors or provide additional information that may have been missing in the initial submission.
03
Clearly label the resubmission with the word 'RESUBMISSION' to ensure it is processed correctly.
04
Follow any specific guidelines or instructions provided by the reviewing authority for resubmissions.
Who needs resubmission of erroneously denied?
01
Individuals or organizations whose submissions have been erroneously denied and have the opportunity to correct the errors or provide additional information for reconsideration.
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What is resubmission of erroneously denied?
Resubmission of erroneously denied is the process of reapplying for a claim or request that was initially denied due to an error.
Who is required to file resubmission of erroneously denied?
Anyone who has had a claim or request erroneously denied and wishes to correct the error and have it approved.
How to fill out resubmission of erroneously denied?
To fill out a resubmission of erroneously denied, one must provide the necessary information requested by the governing body and explain the reason for the resubmission.
What is the purpose of resubmission of erroneously denied?
The purpose of resubmission of erroneously denied is to correct errors in the initial denial and have the claim or request approved.
What information must be reported on resubmission of erroneously denied?
The required information may vary depending on the specific case, but generally, one must report the correct details that were erroneously denied in the initial claim or request.
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