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Last Modified: 4/14/2022 Location: FL, PR, USVI Business: Part A, Part B

SPOT features and functionality

Part A

Part B

Appeal request via claim status
Check the status of a claim as well as submit level 1 (redeterminations) and level 2 (reconsiderations) appeal requests
X
 
Appeal status
Obtain information regarding status of appeals, including the outcome of the appeal
X
X
Appeals outcome
Obtain the outcome of appeal decisions by viewing copies of the redetermination notices
X
X
AR transaction details
Obtain account receivable details including recoupment, adjustment, collection amounts, and duplicate demand letters
X
X
Claim reopening request
Submit a request for a reopening to be performed
X
X
Claim status
Obtain the status of a claim that is accepted into the claim processing system
X
X
Comparative billing report (CR)
Obtain reports, which provide insight into billing trends, and assist providers with self-audits of procedures and billing practices
X
EDI form request
Request an update to the EDI enrollment information
X
X
Eligibility
Check patient eligibility and obtain benefit details
X
X
MBI lookup tool
Look up patient Medicare beneficiary identifier (MBI) numbers
X
X
Medical review claims
View additional documentation request (ADR) status and dates, copies of ADR letters, and status and outcome of the review
X
X
Medical review records submission
Submit requested medical review records in response to ADR letters
X
X
MSP overpayment form
Submit a request for an MSP overpayment to be performed
 
X
Non-MSP overpayment form
Submit a request for a non-MSP overpayment to be performed
 
X
Overpayment correction
Report a duplicate claim, services not rendered, or other correction on a single line or full claim.
X
Overpayment letters
View, save, or print copies of overpayment letters
X
X
Payment status
Obtain check information such as check number, amount, dates, and check status.
X
X
Prior authorization request submissions
Part A and B:
Hospital outpatient department (OPD) services
Part B only:
Submit prior authorization requests for Part B repetitive non-emergent ambulance transportation
X
X
Retrieve remittance advice copies
View, save, or print copies of the remittance like the standard paper remittance (SPR)
X
X
Submit 1099 forms
Submit request for 1099 copies, corrections or to dispute the information
X
X
Submit appeal requests
Submit appeal requests with documentation
X
X
Submit general information requests
Submit general inquiries such as questions related to coverage guidelines, policy issues, or how to bill Medicare
X
X
Submit Provider Audit & Reimbursement documents
Submit documentation to Provider Audit & Reimbursement including supplemental security income (SSI) realignment requests, wage index/occupational mix submissions, cost report reopening requests, and more
X
For instructions on using these features once enrolled for SPOT, access the links below:
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.