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Last Modified: 4/10/2020 Location: FL, PR, USVI Business: Part A, Part B

No claims/payment information FAQ

Q: Why can’t I access claims or payment information for an individual practitioner from our organization?
A: Access to claims, payment, and analytical data is based upon how your organization bills Medicare. Claims and payment information will not return for an individual unless he or she bills Medicare as a separate entity.

Access to claims, payment, and analytical data through SPOT

The return of claims, payment, and analytical information through the Secure Provider Online Tool (SPOT) is based upon the following:
How your organization bills Medicare
The profile associated with your EIDM account and/or the NPI/PTAN combination you select within SPOT

Organizations that bill Medicare as a group

If your organization bills Medicare as a group, professional association, or corporation -- even if the organization has only one practitioner -- only information about the billing entity will be available through the SPOT.
Note: If your organization has more than one practitioner and they bill Medicare as part of the same group/billing entity, then claims and payment information will not be available for each individual practitioner, however your approver may list these NPI/PTAN combinations on the initial enrollment form to retrieve comparative billing reports, which are based on the rendering physician’s information.

Practitioners billing Medicare separately

If each practitioner bills Medicare under his or her own NPI, PTAN, and SSN/TIN -- not as part of a group – then a unique enrollment form would need to be submitted for each practitioner. This will require the approver to create a separate organization/entity within EIDM for each practitioner. The approver may submit a list of additional NPI/PTAN combinations (when applicable and under the same SSN/TIN), on their enrollment form or submit an update form pdf file so these accounts can be created.

How to update your SPOT account billing information

The following updates must be made by approvers through completing a SPOT update form for organizations pdf file:
Add/remove NPI/PTAN combinations
If the additional NPI/PTAN is applied to the same submitter ID as your current organization, no further action is required once approved.
If this is listed under a different submitter ID, the approver must follow the instructions to add a role within EIDM once the update form has been approved.
Once the approver has added the new submitter ID within EIDM, end users may request access to this new account by adding a role. Note: When following these instructions, be sure to select the SPOT end user role as indicated in step 10.
Update legal business name, and/or submitter ID
Note: After receiving approval of the update form, approvers must update their EIDM account (see ‘My Access: View Existing Role Detail’ in these instructions)
The following updates can be made within EIDM
Update company telephone number and/or company address (approver only) (see ‘My Access: Modify Business Contact Information’ in these instructions)
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.