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Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
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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 Medicare.gov 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

Tired of paper?

Secure Provider Online Tool (SPOT)

Did you know you can check claim status and find eligibility and benefits data online?
Modified: 10/3/2019
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: 10/3/2019
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: 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: 10/28/2019
First Coast is implementing 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 new process will benefit you.
Modified: 11/11/2019
Starting January 1, 2020, you must submit only the MBI on Medicare claims. If not, Medicare will reject claims submitted with the health insurance claim number. Let us show you how to act now.
Modified: 11/1/2019
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: 10/16/2019
Starting January 1, 2020, you must submit only the MBI on Medicare claims. If not, Medicare will reject claims submitted with the health insurance claim number (HICN).
Modified: 10/3/2019
This FAQ provides information on timely filing of claims.
Modified: 10/2/2019
Medicare Beneficiary Identifiers can sometimes change. View these scenarios from CMS for when to use the old or new MBI.
Modified: 9/30/2019
This interactive tool provides the basic guidelines for completing the data element requirements for the CMS-1500 (02/12) claim form
Modified: 9/18/2019
Find resources and information on the new Medicare cards. This article includes a link to MLN Matters special edition article SE18006, which was revised on August 19, 2019, to show that all new Medicare cards have been mailed, to encourage providers to use MBIs now to protect patients’ identities, to emphasize that providers must use MBIs beginning January 1, 2020, and to explain the rejection codes providers will get if they submit a HICN after January 1, 2020.
Modified: 9/13/2019
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: 8/27/2019
This document discusses the conditions and requirements of the Item fields within the revised CMS-1500 (02/12) paper claim form.
Modified: 8/24/2019
This document outlines instructions -- for Medicare administrative contractors -- regarding how to request assistance from First Coast Service Options to resolve an overlapping claim.
Modified: 8/22/2019
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 August 19, 2019, to show that all new Medicare cards have been mailed, to encourage providers to use MBIs now to protect patients’ identities, to emphasize that providers must use MBIs beginning January 1, 2020, and to explain the rejection codes providers will get if they submit a HICN after January 1, 2020. All other information remains the same. [SE18006]
Modified: 8/22/2019
When billing for unlisted drug codes, include the name, strength, and dosage of the drug. [CMS IOM Pub 100-04, Ch. 17]
Modified: 8/16/2019
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: 8/16/2019
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: 4/24/2019
This tutorial focuses on areas of the CMS-1500 (02/12) form where errors occur, including items containing NPI numbers.
Modified: 4/24/2019
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: 4/2/2019
This article provides beneficiary guidelines for submitting claims rendered in Florida, U.S. Virgin Islands, or Puerto Rico.
Modified: 2/1/2019
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.