Term that refers to informal revisiting of a claim payment decision that has been made by a Medicare fiscal intermediary. Situations for reopening are (1) after appeal rights are exhausted, (2) after the time limit for requesting an appeal has expired, (3) 12 months to 4 years after the date of the initial decision, (4) when a decision is unfavorable, (5) to correct a clerical error for fraud, or (6) in response to a court order. Also called revisit .

1. Remedial action taken after all appeal rights of a denied insurance claim are exhausted, to reexamine or question the correctness of a determination, a decision, or cost report otherwise final. 2. To resolicit an insurance plan to an employer for enrollment of his or her employees who were not previously enrolled.