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.

Insurance claims in which information has been changed, corrected, and resubmitted and is not the same as a duplicate claim.

Medicare Part B recurring services billed monthly or at the conclusion of outpatient treatment such as cardiac rehabilitation services; home health visits; kidney dialysis treatments; psychological services; rental of durable medical equipment; therapeutic nuclear medicine; therapeutic radiology; respiratory, physical, and occupational therapy; and speech pathology. Also called recurring outpatient services or series outpatient services .