Last Modified: 9/3/2018 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.
Medicare beneficiary numbers are changing in 2018
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Medicare number on new Medicare cards starting in 2018 for Medicare transactions like billing, eligibility status, and claim status. Find more details here.
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
• Claim returned -- see Return to provider (RTP) reason code 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
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.