Last Modified: 4/11/2024
Location: FL, PR, USVI
Business: Part A, Part B
If you answered yes, it may be due to the address you have on file with Medicare and Medicaid. When Medicare crosses over your claim to Medicaid the following address fields are submitted:
• Master address
• Pay-to (or remit address) (if they are different on Medicare's system)
If Medicaid does not have the same addresses in their file, Medicaid will reject the claim.
Medicaid validates the crossover claims as follows:
1. National provider identifier (NPI)
2. NPI to taxonomy code (if applicable)
3. NPI to ZIP code
• Verify you have the exact same addresses on file with both Medicare and Medicaid
• Make sure your addresses are current and in the
ZIP+4 (i.e., nine-digit ZIP code) format
Florida
To update your addresses with Medicaid, you have two choices.
• Contact Medicaid's provider enrollment customer service lines at 1-800-289-7799 (option 4), and they will fax the appropriate paperwork to you.
Medicaid also requires a notarized copy of your W9 -- showing your new address -- which may be submitted via fax. Their fax number is 1-866-270-1497.
You may use Medicaid's web portal to create a fax coversheet, which should include Attention: Provider Enrollment. Medicaid also recommends you add your provider ID number to all pages within your document (including the fax cover sheet).
Puerto Rico
To update your addresses with Medicaid, you have two choices.
• To update your information, click the “edit” link next to the address needing to be updated.
• Contact Medicaid's provider enrollment customer service line at (787) 641-4200, and they will fax the appropriate paperwork to you.
Medicaid also requires a notarized copy of your W9 -- showing your new address -- which may be submitted via fax. Their fax number is (787) 763-5250. Medicaid also recommends you add your provider ID number to all pages within your document (including the fax cover sheet).
U.S. Virgin Islands
To update your addresses with Medicaid:
• Access the
USVI Medicaid Online Portal , hover over the "Reference Material" section at the top of the page and select the
Forms hyperlink. The
Forms hyperlink contains documents used to request an authorization, change an address, the enrollment application, and other important documents.
• Complete the
USVI Medicaid Program Provider Change of Address form to document a change of address, whether mailing or physical. Note: This form must be returned with an
original signature to VI Medicaid Program Provider Enrollment department:
VI Medicaid Program Provider Enrollment
Department of Human Services
1303 Hospital Ground
Knud Hansen Complex, Bldg. A
St. Thomas, USVI 00802
Contact Medicaid's provider enrollment customer service line at (340) 715-6929 for additional assistance.
First Coast Service Options (First Coast) 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.