Last Modified: 12/28/2017 Location: FL, PR, USVI Business: Part A, Part B
SPOT transfer form deadline extended
Due to impacts from Hurricane Irma and Hurricane Maria, First Coast Service Options Inc. (First Coast) has extended the deadline for SPOT users to submit their required transfer form. The new deadline is January 31, 2018.
Each provider entity that has one or more users with an active SPOT account must submit a transfer form designating the primary office approver and the backup office approver no later than January 31, 2018, or risk losing access. Click here to access the form and follow the directions for completion and submission.
The transfer form must be signed with a written/electronic signature by the authorized official or the delegated official as shown on the CMS-855 enrollment form that was submitted when the entity enrolled in the Medicare Program in order to be approved. In addition, the form requires the following elements to match the CMS-855 enrollment form in order to be approved:
• The legal business name of the entity;
• the billing/group PTAN/NPI/TIN;
• the location, (i.e., Florida, Puerto Rico or the U.S. Virgin Islands), and;
• whether the entity is an institutional provider (Part A) or a professional provider (Part B)
How to avoid rejection of your form
Of the required SPOT transfer forms First Coast has received so far, many have been rejected for one or more reasons. It is crucial that information on the transfer form is correct for submission or users will lose their SPOT access. If your form has been rejected, you will receive communication and must submit a corrected transfer form before the January 31 deadline. The reasons forms are being rejected are:
1. Information on the transfer form does not match information shown on the CMS-855 enrollment form that was submitted when the entity enrolled in the Medicare program in order to be approved, including the legal business name of the entity and the billing/group PTAN/NPI/TIN.
2. The individual signing the form is not an authorized or delegated official on the CMS-855 enrollment form.
3. The PTAN and NPI do not match the billing provider. (Do not use the PTAN/NPI of the performing provider.)
Information on the transfer form must match the information found on the CMS-855. The CMS-855 can be located by logging into internet-based Provider Enrollment, Chain, and Ownership System (PECOS) . In addition, you can log into your SPOT account to confirm your account information.
Click here to access the transfer form and follow the directions for completion and submission.
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.