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This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
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Claim submission guidelines

Modified: 9/29/2022
Read this important article to learn about compliance with the mandatory Medicare claim submission requirements.
Modified: 2/10/2021
To be considered filed timely, a claim must be submitted no later than one year after the date of service. If a claim is returned as unprocessable, it has not been filed successfully.
Modified: 2/6/2021
To be considered filed timely, a claim must be submitted no later than one year after the date of service. If a claim is returned to the provider, it has not been filed successfully.
Modified: 5/28/2019
This article provides guidance for billing provider-liable acute inpatient noncovered and acute partial inpatient noncovered days, and acute inpatient noncovered beneficiary-liable days.
Modified: 9/15/2022
First Coast has implemented a new process to reduce provider burden and process claims more efficiently. If you submit claims for skin substitutes or radiopharmaceutical codes, learn how this process will benefit you.
Modified: 10/21/2022
First Coast is providing new billing and coding instructions for hemophilia clotting factor products. Effective for claims processed on or after September 13, 2021, hemophilia clotting factor products not billed following this new direction will be denied.
Modified: 10/1/2022
Want to learn the key differences between Original Medicare and a Medicare Advantage plan? Take a look at our YouTube video.
Modified: 10/1/2022
Modified: 9/30/2022
Are you submitting claims for non-covered dental services to receive the denial? Review this article for details on submitting claims for these non-covered services.
Modified: 9/30/2022
View this article to learn about First Coast’s new coversheet for hardcopy UB-04 form submissions.
Modified: 9/3/2022
Correct coding requires services to be reported with the most specific code available that appropriately describes the service. This article has been revised to reject claims not billed correctly. Please read this article to learn more.
Modified: 8/31/2022
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Modified: 5/27/2022
First Coast recently made changes to how we handle paper claims marked for "other insurance". Review this article to avoid claim rejections of this kind.
Modified: 4/24/2022
When billing for unlisted drug codes, include the name, strength, and dosage of the drug. [CMS IOM Pub 100-04, Ch. 17]
Modified: 4/14/2022
The following information discusses the conditions and requirements of the item fields within the CMS-1500 (02/12) paper claim form and the electronic equivalent elements.
Modified: 4/7/2022
First Coast has been made aware of complaints by beneficiaries being required to pay for services up front. This article explains what may occur when indicating a patient payment amount on a claim and provides solutions when assignment is accepted.
Modified: 11/5/2021
Use this form before doing a hardcopy claim submission.
Modified: 8/3/2021
This interactive tool provides the basic guidelines for completing the data element requirements for the CMS-1500 (02/12) claim form
Modified: 8/3/2021
Tired of having claims returned because you didn't complete the primary insurance section of the CMS 1500 (02/12) form? This short tutorial focuses on how to complete the patient information section of the CMS-1500 (02/12) form.
Modified: 8/3/2021
This tutorial focuses on areas of the CMS-1500 (02/12) form where errors occur, including items containing NPI numbers.
Modified: 5/2/2021
This FAQ provides information on timely filing of claims.
Modified: 2/11/2021
First Coast has noticed an increase in errors on the CMS-1500 (02/12) claim form. This article addresses important instructions regarding completion of the paper claim form.
Modified: 11/6/2020
This document outlines instructions -- for Medicare administrative contractors -- regarding how to request assistance from First Coast Service Options to resolve an overlapping claim.
Modified: 10/4/2020
This article provides beneficiary guidelines for submitting claims rendered in Florida, U.S. Virgin Islands, or Puerto Rico.
Modified: 9/26/2020
This fact sheet is designed to provide guidance to health care professionals and suppliers who transmit health care claims electronically or use paper claim forms. It includes information about Medicare claims submissions, coding, submitting accurate claims, when Medicare will accept a hard copy claim form, timely filing, and where to submit FFS (fee for service) claims.
Modified: 9/10/2020
There are three ways to obtain the Medicare Beneficiary Identifier (MBI), which is effective when the beneficiary was or is eligible for Medicare. This article was most recently revised March 19, 2020, to clarify that the beneficiary’s first name, last name, date of birth, and SSN are needed to use the MBI lookup tool. All other information remains the same. [SE18006]
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.