This application provides confirmation that appeal requests have been received by First Coast Service Options (First Coast). Please enter all of the information requested below.
Note: Please ensure the information you enter is exactly as it appears on your remittance advice or obtained from the IVR. This application will only reference one claim number from multiple claims appealed on one redetermination form. To acquire acknowledgement of claims appealed in this manner, it is recommended that you search by PTAN.
First Coast is committed to processing your appeal request as quickly as possible and to ensuring the appeals acknowledgement application contains current information. However, due to fluctuations in the volume of requests received, system updates may be delayed.
Please allow 15 days after you have submitted your appeal request before confirming receipt in the lookup application or contacting customer service.
Please note: (*) indicates the field is required.
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.