This connectivity guide provides trading partners with instructions on how to successfully exchange electronic transactions with First Coast using the hypertext transfer protocol secure (HTTPS) Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules (CORE) compliant rules over the public internet.
A provider may submit a waiver request to their Medicare administrative contractor (MAC) claiming an “unusual circumstance” outside of their control prevents the submission of electronic claims. [CR 10559]
The HETS is intended to allow the release of eligibility data to Medicare providers, suppliers, or their authorized billing agents for the purpose of preparing an accurate Medicare claim, determining beneficiary liability or determining eligibility for specific services.
Tips to avoid rejection of your Medicare EDI enrollment form. Avoid pitfalls when completing the EDI enrollment form. Submit your EDI enrollment form correct the first time and avoid processing delays.
These guides on the Centers for Medicare & Medicaid Services (CMS) website provide communication, connectivity, and transaction specific information to Medicare FFS trading partners and serve as the authoritative source for Medicare FFS-specific electronic data interchange (EDI) protocols. [CR 7373]
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.