skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
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.
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 10/3/2020 Location: FL, PR, USVI Business: Part A, Part B

Paperwork (PWK) fax/mail/esMD coversheet

The PWK fax/mail coversheet was revised to remove the health insurance claim number (HICN) and replace it with "Medicare ID" as part of the Medicare Access and CHIP Reauthorization Act of 2015, which requires removal of the Social Security number-based HICN from Medicare cards.
As a result of this change, Medicare contractors shall accept only the new PWK fax/mail/esMD coversheets that contain "Medicare ID" effective April 2, 2018. Providers who downloaded PWK forms prior to April 2, 2018, should delete them and use only the new forms.
Note: if an “old” form is received it will not be processed. Prior versions cannot be accepted.
The revised PWK fax/mail/esMD coversheets are available through the links below:
Source: The Centers for Medicare & Medicaid Services Change Request 10124
Source: CR 10397
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.