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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: 4/4/2024 Location: FL, PR, USVI Business: Part A

Common inquiries -- Part A

What SPOT Can Do For You

"With our snowbirds, we have to stay on top of their eligibility status," said one Medicare billing manager who uses First Coast's SPOT to access eligibility information. "Having fast access to Medicare eligibility and secondary payer information helps us file clean, accurate claims and get reimbursed sooner."
Click here to find out what SPOT can do for you.

Reduce the time you spend contacting Medicare

First Coast Service Options’ Part A provider contact center frequently receives inquiries from our provider community about a wide array of topics. Listed below are some of the most popular topics as well as links to information that will help you find the answers you need to resolve any issues quickly and easily.

If you have a question related to:

Appeals status/explanation/resolution -- see Appeals FAQs -- Part A
Beneficiary's eligibility or entitlement to Medicare -- see Eligibility FAQs
Claim in suspense or pending completion
Claim pending 30 days or less -- please allow up to 14 days for claims submitted electronically and 30 days for paper claims to complete processing.
Claim in suspense or pending more than 30 days -- click here for processing issues
Claim not on file -- click here
Claim rejected -- see Reject reason FAQs
Medicare secondary payer (MSP) -- click here
Overlapping claims -- see Claims overlap FAQs
Overpayments -- see Overpayment FAQs
Processing Issues -- click here
Other frequently-asked questions -- click here

Additional tips

Use the following tips to help you find the answers you need about these additional topics:
Click here for questions about accessing claim status, patient eligibility (Medicare, MSP and Medicare Advantage [formerly Medicare HMO]), deductible information, and financial information (last three checks, month/year to date dollar amounts).
For inquiries other than those listed above, contact First Coast’s Provider contact center. When calling the Provider contact center, make sure you have all the information necessary for the call. You can do this by viewing the Provider inquiry checklist
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.