Last Modified: 2/28/2025
Location: FL, PR, USVI
Business: Part A, Part B
First Coast develops educational campaigns to focus our outreach efforts on topics or initiatives that matter most to our providers and beneficiaries we serve.
You ask, we deliver. Our
education programs in 2025 represent the most relevant, requested topics by our providers.
Medicare Navigator Programs
The Medicare Navigator Workshop concept is new to our program in 2025. Our unique approach recognizes successful participation in our Medicare Navigator events through the issuance of digital badges with an opportunity to promote to Medicare Navigator Champion status and receive the ultimate badge.
StayConnected Workshops
Our StayConnected Workshops present prioritized Medicare topics in a consolidated, rotational format offered within a single week. We invite you to attend all events offered within the series or only those that apply to you. The benefit of attending a StayConnected program is you obtain and retain the knowledge from each session and apply it directly to the next event. Stay connected with Medicare updates and requirements and participate in our next workshop series.
Visit our
event calendar for a listing of webinars open to registration. This list is constantly changing from month-to-month, so continue to monitor it for updates.
Do you use a third-party vendor or outsourced company for your Medicare credentialing, billing, and account receivables? Do you know who is using your data? Do you know how they are using your data? How much is it costing you?
• First Coast has experienced a large increase in unnecessary telephone calls from third parties and outsourced agencies representing our providers. Help us prevent these unnecessary requests for assistance to our Customer Contact Center by reviewing this helpful article
Compliance Matters: Third-Party Vendors, Outsourced Agencies and You.
Third-party vendors, also referred to as outsourced agencies or business associates/partners, and Medicare providers have an equal obligation to maintain Medicare compliance. Learn more about how to establish efficient controls, risk assessments and an overall compliance program to mitigate fraud, waste, and abuse of the Medicare program.
CERT is responsible for measuring improper payments in the Medicare Fee-for-Service (FFS) program. CERT selects a stratified random sample of approximately 50,000 claims that allows CMS to calculate a national improper payment rate and contractor- and service-specific improper payment rates.
Did you know that not responding to a CERT request for medical records will cause a claim error and denial of your claim? It is important you respond to the CERT request to help reduce claim denials and to lower the error rates.
• Be proactive, ensure your contact information is current with the MAC. The CERT additional documentation request (ADR) letters are sent to the provider’s address on file with the MAC found under the “Medical Record Corresponding Mailing Address" in PECOS.
For additional information on how to update your address, please visit:
CERT allows medical records to be submitted through all communication channels: Mail, fax, electronic submission of medical documentation (esMD), CD, or email attachment.
Our
CERT specialty webpage offers a variety of tools and resources to help you save time and money. Visit today!
As an attempt to simplify the Medicare process for the provider community, we have constructed a tool to guide someone new to the Medicare program through the various Medicare processes and transaction types. Throughout the
New Provider Roadmap, hyperlinks to our resources will be provided to help further your knowledge of the Medicare program.
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? The
FastTrack to Medicare Coverage Policies tool provides a hierarchy of critical resources to determine if a Medicare policy exists, and if not, what to do next.
• The 'Avoid the Wait' (
Part A)(
Part B) resource page provides a consolidated listing of all electronic submission methods available to send documentation to First Coast. Save time and money by exploring these options instead of using costly printing and shipping methods. Many of these submission methods provide immediate confirmation of receipt giving you peace of mind your documentation was successfully received by us.
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.
