Last Modified: 1/29/2010
Location: FL, USVI
Business: Part B
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.
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. to 6:30 p.m. ET
Saturday 7:00 a.m. to 3:00 p.m. ET
Providers in Florida have the option of selecting speech or touchtone when using the IVR. Touchtone is available to providers in the U.S. Virgin Islands and Puerto Rico. In order to receive the maximum results that 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 and 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 an 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 that 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#
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 via the IVR:
• National Provider Identifier (NPI)
• Tax Identification Number (TIN)
• Provider Transaction Access Number (PTAN)
• Beneficiary Medicare number
• Beneficiary name,
• Beneficiary date of birth
• Date of service (If applicable)
1. General information
2. Status and reopenings
3. Eligibility
4. Pending claims
5. Check status
6. Remittance codes/pricing
7. Enrollment information
• For information about Medicare changes and issues, press 1
• For general appeals information, press 2
• For provider customer service hours of operation and best times to call, press 3
• For the Medicare Part B of Florida Web site, press 4
• For information that you will need when calling Medicare, press 5
• For the list of information offered by the IVR, press 6
• For claim status, press 1
Assigned claim status
Pending, finalized, denied
Date of service
Amount submitted
Processed date
Deductible
Payment amount
Payment date
Check number
Internal Control Number (ICN)
Supplemental insurance (Forwarded or not)
Non - assigned claims
Processed date
Amount submitted
Payment date
• Additional claim detail
*This menu is offered after the information above has been voiced.
• Procedure code
• Date of service
• Billed amount and allowed amount for each procedure code
• Denial message
• For correspondence status, press 2
• IVR will voice date correspondence was completed and the Correspondence Control Number (CCN)
• To request a telephone reopening of a claim, press 3
This option provides callers with the ability to request a telephone reopening on a single detail line of a claim with the exception of hospice and entitlement related services.
Changes to date of service, press 1
To add, delete, or change a modifier, press 2
To change a diagnosis, press 3
Note: This option is only for the primary diagnosis for a procedure.
To have MSP, entitlement and Medicare Advantage claim denials reprocessed, press 4
• For current eligibility information, press 1
• Entitlement date
• Termination date (if applicable)
• Part B deductible
• Current Year deductible
• Previous Year deductible
• Medicare Advantage information
• Medicare is primary or secondary
If a Medicare Advantage plan is found, you can press 1 for more information.
• Medicare Advantage number
• Plan type
• Plan name
• Effective and termination date of policy
• Address of Medicare Advantage servicing provider
If Medicare is secondary, press 1 for MSP details
• Type of primary insurance
• Effective and termination date for all valid Insurers
• (Current or previous date of service)
• For eligibility for a previous date of service, press 2
• For physical and occupational therapy information, press 3
• For Medicare Advantage Plan 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 - The Medicare Advantage plan number was formerly known as HMO Plan number.
Note: After primary eligibility information is obtained, the IVR will prompt the caller to press an option for additional eligibility.
• 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
• For pending claim information, press 1
• For month or year-to-date dollar amount, press 2
• For the last three checks, press 1
• For check history by issue date, press 2
• For check history by check number, press 3
• For remittance code information, press 1
• For pricing of a procedure code, press 2
• 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
This option returns callers to the main menu.
This option ends the call in the IVR.
8:00 a.m. - 4:00 p.m. Monday through Friday, ET and CT for providers in Florida, excluding holiday closings, and
7:00 a.m. - 3:00 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 B provider call centers are typically closed for staff training purposes on Fridays from 2:00 p.m. to 4:00 p.m. ET in Florida and the U.S. Virgin Islands.
General Written inquiries -- Medicare Part B issues
Florida and the U.S. Virgin Islands
Puerto Rico
