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Last Modified: 6/11/2010 Location: FL, USVI Business: Part A

Part A interactive voice response (IVR) operating guide
1-877-602-8816

First Coast Service Options, Inc. (FCSO) strives to provide you with the most up to date automation features as possible. The IVR operating guide will help to increase your knowledge of the technology and services we offer our providers. You may also find our IVR Quick Reference Guide helpful.

Hours of operation

IVR unit hours of availability
The IVR is available 24 hours a day, 7 days a week, except for regularly scheduled maintenance. However, specific claim and/or eligibility information is available during the following times, with the exception of Holidays:
Monday-Friday 7:00 a.m. - 7:00 p.m., ET
Saturday 7:00 a.m.-3:00 p.m., ET

Touchtone or speech

All callers have the option of selecting speech or touchtone when using the IVR. In order to receive maximum, results you deserve when speaking we offer the following tips:
Use a telephone with a handset or headset
Avoid using a speakerphone or cell phone
Avoid calling from areas with loud background noise
Speak the requested information clearly in a quiet environment
*When using the speech recognition option on the IVR, and keying the date is required (date of service, date of birth, etc.), the date must be given in 8-digit format (mm/dd/yyyy).
In the event the system does not accept the spoken information, touch-tone is always available. In order to receive the maximum results you deserve when using touch-tone we offer the following tips:
Dates should be entered in the following format (mm/dd/yy)
To signal you are entering an alpha suffix or letter, press the * key
Press the key that includes the letter, then the corresponding number that denotes where the letter is located on the number key.
After all letters desired have been keyed, press the pound (#) sign to end your entry.
Use the numbers on the telephone keypad that corresponds to the patient or provider number:
A = *21#
Q =*72#
R = *73#
Z = *94#

Helpful tips

As a result of the Health Insurance Portability and Accountability Act (HIPAA), we are required to protect the privacy of all individuals. You must have the following information available for authentication to access patient eligibility, deductible and claims information from the IVR:
National Provider Identifier (NPI)
Provider Transaction Access Number (PTAN)
Beneficiary Medicare number
Beneficiary name,
Beneficiary date of birth
Date of service (if applicable)

Main menu -- number/options

1. Common questions
2. Claim status
3. Check status
4. Publication information
5. Eligibility
6. Remittance codes
7. Enrollment information

Providers’ commonly asked questions - Press 1

How to bill a claim, press 1
How to receive status of a claim, press 2
How to know if a HCPC code is bundled, press 3
For general appeals information, press 4
For hours of operation, press 5

Claim status - Press 2

For Claim status, press 1
The IVR voices the following information:
Type of bill
Amount submitted
Date claim received
Reimbursement amount
Document Control Number (DCN)
Remittance advice date
The IVR voices the following information when it is returned to the provider:
Date claim received
Amount submitted
Date returned
Document Control Number (DCN)
Reason code
Reason for return
The IVR voices the following on pending claims:
Date claim received
Amount submitted
Document Control Number

Check information - Press 3

To obtain the amount of your last check, press 1
For information on a specific check, press 2
For information on your last three checks, press 3

Publication information - Press 4

For information on Medicare seminars, press 1
For information on CMS publications, press 2
For information on Medicare Part A publications, press 3

Eligibility information - Press 5

For current eligibility information, press 1
Part A and B entitlement date
Part A and B termination date (if applicable)
Part B deductible information
Current Year deductible
Previous Year deductible
Full hospital days remaining
Hospital co insurance days remaining
Full skilled nursing facility days
Skilled nursing facility co insurance days
Lifetime reserve days remaining
Lifetime psychiatric days remaining
Last billing date
Medicare Advantage information
Medicare is primary or secondary
If Medicare Advantage Plan is found, you can press 1 for more information.
The IVR will give the Medicare Advantage number
Plan type
Plan name
Effective dates and termination date of policy
Address of Medicare Advantage servicing provider
If Medicare is secondary, press 1 for additional MSP details
Type of primary insurance
Effective and termination date for all valid insurers for either current or previous date of service.
For eligibility for a previous date of service, press 2
For physical and occupational therapy Information, press 3
Medicare Advantage (formerly known as HMO) information - Press 4
enters a specific Medicare Advantage plan number to receive specific information such as:
Plan name
Type of plan
Address of plan provider
Note: After primary eligibility information is obtained, the IVR will prompt the caller to press an option for additional eligibility.

Sub menu for additional eligibility menu

Hospice
Hospice effective date
Termination date (if applicable)
Servicing provider number
Home health
Home health effective date
Termination date (if applicable)
Servicing provider number
Skilled nursing facility
SNF effective date
Termination date (if applicable)
Servicing provider number

Definitions of remittance codes - Press 6

For remittance code information, press 1

Enrollment information – Press 7

For status of an enrollment application, press 1
For a summary of applications and when to use them, press 2
For a summary of documents required for certain specialties, press 3
For mailing address and PECOS internet enrollment information, press 4
For open enrollment and participation in Medicare information, press 5
For a summary of enrollment information available on our website, press 6

Repeat menu - Press 8

This option returns callers to the main menu

End call - Press 9

This option ends the call in the IVR.

Additional information

Customer service representatives—Medicare Part A
8:00 a.m. - 4:00 p.m. Monday through Friday, ET and CT for providers in Florida, excluding holiday closings, and
8:00 a.m. - 4:00 p.m. Monday through Friday, ET for providers in the U.S. Virgin Islands, excluding holiday closings.
Toll-free telephone number: 1-888-664-4112
Speech and hearing impaired: 1-877-660-1759
Training hours
The FCSO Medicare Part A provider call centers are typically closed for staff training purposes on Fridays from 2:00 p.m. to 4:00 p.m., ET.
General written inquiries -- Medicare Part A issues
Florida, U.S. Virgin Islands
Online submission: Ask Florida A
Website links
For additional information, visit the Centers for Medicare & Medicaid Services’ (CMS) website at www.cms.gov/home/medicare.asp external link
Part B

First Coast Service Options (FCSO) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.