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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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EDI forms

EDI feedback
Modified: 11/25/2022
This new interactive “Electronic Data Interchange (EDI) enrollment form” has been revised. This form is intended for provider use only and replaces previous EDI enrollment forms. Previous forms will not be accepted as of August 16, 2022.
Modified: 10/31/2022
First Coast would like to remind providers that EDI enrollment forms may be submitted via email, fax, and SPOT.
Modified: 8/19/2022
This new interactive form is for third-party agents such as clearinghouses and billing services to enroll for electronic transactions. [CR 8756]
Modified: 7/17/2022
This new interactive “Electronic Data Interchange (EDI) submitter update request form” has been revised as of July 2022.
Modified: 3/19/2021
This new interactive "Third Party HTTPS CAQH CORE EDI Enrollment Form” is intended for third party trading partners such as billing services or clearinghouses. Please see the HTTPS CAQH CORE Connection Guide for connectivity requirements. This form was updated in October 2019. Any previous versions of this form will not be accepted as of December 1, 2019.
Modified: 2/24/2021
This new interactive "Provider Third Party HTTPS CAQH CORE EDI Enrollment Form” is intended for trading partner provider use only. Please see the HTTPS CAQH CORE Connection Guide for connectivity requirements.
Modified: 12/4/2020
Use this form for voluntary submission of supporting documentation with a version 5010 electronic claim. This is NOT an EDI enrollment form. [CR 10397]
Modified: 12/4/2020
Use this form for voluntary submission of supporting documentation with a version 5010 electronic claim. This is NOT an EDI enrollment form. [CR 10397]
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.