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LICENSE FOR USE OF "PHYSICIAN'S CURRENT PROCEDURAL TERMINOLOGY" (CPT), FOURTH EDITION End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2022 American Medical Association (AMA).

All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials:
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internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare and Medicaid Services (CMS), formerly known as Health Care Financing Administration (HCFA). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website. Applicable FARS/DFARS restrictions apply to government use.

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AMA - U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a )June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

ADA CURRENT DENTAL TERMINOLOGY, (CDT)
End User/Point and Click Agreement: These materials contain Current Dental Terminology (CDTTM), Copyright © 2016 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

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Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the ADA website.

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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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Last Modified: 10/3/2022 Location: FL, PR, USVI Business: Part A, Part B

TIBCO Connectivity Guide

Important tips for configuring your Secure File Transfer Protocol (SFTP) file:

Disable “temp file” in your file transfer software.
The date/time stamp during file transfer should not be updated.
A file should not be renamed after the last byte of the file has been transferred.
Submitting .ZIP files is supported by First Coast; however, we recommend that they only be submitted to decrease the byte size of larger X12 EDI inbound files. Please follow the below best practices when submitting .ZIP files:
Only one large X12 file should be submitted in the .ZIP package.
The file name should not have spaces or special characters.
Do not encrypt or password protect the file.
Only a file should be zipped, not an entire folder.

Free Medicare software

Medicare Remit Easy Print (MREP) is available to translate the 835 ERA for Part B.
PC Print is available to translate the 835 ERA for Part A.
PC-ACE is available to create 837 claim files and translate the 835 ERA for Part A and Part B for approved PC-ACE users

Setting up the SFTP program

If you have enrolled for SFTP, complete the following steps to set up the program:
Update the SFTP connection following the SFTP connection section details below.
Verify that the Interchange Receiver ID (ISA08) contains the contract ID for all 837 and 276 claim files. Please work with your software vendor to ensure the ISA08 contains the appropriate contract ID prior to submitting claims over the TIBCO EDI Gateway. Provided below are the First Coast contract IDs based on region.
Medicare A Florida: 09101
Medicare A Puerto Rico/U.S. Virgin Islands: 09201
Medicare B Florida: 09102
Medicare B Puerto Rico: 09202
Medicare B U.S. Virgin Islands: 09302
Retrieve the TA1, 999 and 277 claim acknowledgement reports from the TIBCO gateway after sending files to the TIBCO gateway.
NSV - update the host name used when connecting to First Coast.
Providers, Billing Services, and Clearinghouses:
Set up your initial password.
Access the EDI Gateway Password Change tool
Enter your Mailbox ID.
Enter the initial password, which is assigned as Fcs#LLLL where LLLL represents the last 4 characters of your submitter ID.
Enter a new password.
Enter the new password a second time to confirm.
Click Submit. A message will indicate that your password has been successfully updated.
Connect to First Coast using your NSV product. Enter your current Login ID and the initial password.

Steps to transmit a file

To send electronic claim files via SFTP:
Upload 837 files to:
/outbox/X12/EDI/Inbound/Interchange for X12 files
/outbox/EZComm/BC/1.0/Notify for ZIP files

How to download reports

To pull electronic reports via SFTP:
Retrieve the ANSI X12N 999 report response from:
/inbox/X12/EDI/Outbound/Interchange for X12 files
/inbox/EZComm/BC/1.0/Notify for ZIP files
Note: If the 999 is not available, retrieve the ANSI X12N TA1 file, correct the errors and resend the ANSI X12N 837 file until accepted. The TA1 report location is: /inbox/X12/00501/EmptyGroup/TA1
Open the ANSI X12N 999 file and interpret the report. If rejected, please correct the errors, and resend the ANSI X12N 837 file until accepted.
Note: When opening files for the first time, you may need to choose a basic text editor program from your computer such as notepad. If you choose a program like Adobe or Internet Explorer, you will receive error messages indicating the file will not open. A text editor program must be chosen for these reports. If your browser defaults to a program that will not read the file, the browser settings will need to be updated to choose a text editor program.
After receiving an accepted ANSI X12N 999 report, retrieve the ANSI X12N 277CA report from the same location as the ANSI X12N 999 report indicated in step 5.
Open the ANSI X12N 277CA file and interpret the report.
Continue to send all 837 electronic claim files and retrieve all electronic reports through the new gateway connection.
Contact your NSV with any questions or concerns with the new gateway connection.
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.