Last Modified: 3/3/2025
Location: FL, PR, USVI
Business: Part A, Part B
Eligibility information is available through the free SPOT online portal and the First Coast Interactive Voice Response (IVR) telephone system. It is important for all providers to use SPOT to obtain eligibility. Once enrolled for SPOT, you can obtain the eligibility information quickly with a simple sign-in, a few clicks, and entering basic search criteria.
The eligibility information provided in SPOT is organized into different sections:
• Inquiry – subscriber information and date of service entered in search criteria
• Beneficiary – subscriber name, address, date of birth, Medicare #, date of death, and the date of service range used in the search criteria
• Eligibility – entitlement reason, Part A/Part B effective and termination dates, inactive periods, ESRDS, and Acupuncture benefits
• Deductible – Year Part A/B remaining deductible amounts, free services, blood deductible, therapy CAP, and rehabilitation sessions
• MAP – contract name, contractor #, plan number, plan name, plan type, MA bill opt code, effective date, term date, address, and telephone number
• MSP – type code, effective and termination date, diagnosis code, policy number, group number, patient relationship, ORM indicator, insurer name, and address
• Home Health Care – home health certification details, HHEH start and end date, DOEBA and DOLBA dates, patient status code, notice of admission indicator, provider number, contract name, contract number, and hospice information
• Preventative – COVID-19 immunizations, smoking cessation session info, MDPP usage, preventive services, and cognitive services
• Inpatient – hospital stay information, hospital data, skilled nursing facility data, and psychiatric information
• QMB – QMB Medicaid enrollment dates/type, QMB deductible info, QMB inpatient spell dates, QMB hospital information, and QMB SNF information
• PBID – effective and termination dates
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.