Retraction Request Worksheet

If a reconsideration of claims, the Retraction Request Worksheet should be completed.  This ensures correct claims be reconsidered as well as provides a way of tracking and documenting reconsideration requests.

The Retraction Request Worksheet should be submitted to the RECON fax queue 231-403-5102
Creation date: 7/10/2019 11:29 AM (ssircely@nmre.org)      Updated: 3/29/2022 3:10 PM (hserven@nmre.org)
Files
Retraction Request Worksheet for Providers.xlsx
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