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Claim submission guidelines

Tired of paper?

Secure Provider Online Tool (SPOT)

Did you know you can check claim status and find eligibility and benefits data online?
Modified: 1/9/2017
This article outlines the process for timely filing overrides for the provider community.
Modified: 1/3/2017
Are you submitting paper claims? When completing the claim form, ensure to use all capital typeface. This article addresses important instructions regarding completion of the paper claim form.
Modified: 12/7/2016
This article provides guidance on how to avoid claim errors when billing current procedural terminology codes 98960, 98961 and 98962.
Modified: 12/7/2016
This article provides billing guidance when a beneficiary is admitted as inpatient prior to their Medicare Part A entitlement date.
Modified: 12/7/2016
This article provides beneficiary guidelines for submitting claims rendered in Florida, U.S. Virgin Islands, or Puerto Rico.
Modified: 12/7/2016
Are you submitting paper claims? This article addresses important changes to the CMS-1500 paper claim form, which became effective April 1, 2014, and could affect your claim submissions.
Modified: 12/2/2016
This calculator will assist you in determining when additional documentation requested by First Coast Service Options Inc. must be received.
Modified: 11/28/2016
First Coast Service Options (First Coast), frequently requires a clinical review of records to determine the medical necessity of services.
Modified: 10/31/2016
This document discusses the conditions and requirements of the Item fields within the revised CMS-1500 (02/12) paper claim form.
Modified: 10/26/2016
This tutorial will demonstrate the diagnosis relationship lookup tool to assist in determining if a procedure to diagnosis relationship exists for the procedure performed.
Modified: 10/17/2016
First Coast was recently 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: 10/14/2016
When billing for unlisted drug codes, include the name, strength, and dosage of the drug. [CMS IOM Pub 100-04, Ch. 17]
Modified: 10/13/2016
To facilitate the successful completion of Part A to B rebilling, First Coast Service Options’ (First Coast) has prepared these tips to help submitters avoid billing errors.
Modified: 9/12/2016
This tutorial focuses on areas of the CMS-1500 (02/12) form where errors occur, including items containing NPI numbers.
Modified: 9/12/2016
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: 7/2/2016
This document outlines instructions -- for Medicare administrative contractors (MAC) -- regarding how to request assistance from First Coast Service Options (First Coast) to resolve an overlapping claim.
Modified: 2/28/2016
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.
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.