Intensive outpatient program (IOP) billing requirements for institutional services
Effective January 1, 2024, IOP services are available for both individuals with mental health conditions and individuals with...
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Prior authorization for ambulance transports is for repetitive transports
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a...
Prior authorization: Facet joints and cervical fusion
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn...
Ambulance modifiers
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance...
Prior authorization fax coversheet
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or...
Hospice: New requirement for physicians who certify patient eligibility
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims...
The SPOT User Guide: Section 1 - Introduction
First Coast’s Secure Provider Online Tool (SPOT)
First Coast developed its provider internet portal application - SPOT - to offer...
PC-ACE User Guide: Section 2 - Claim entry
More information on claim entry, including screen shots of the software, is available in the PC-ACE Institutional Training...
PC-ACE User Guide: Section 3 - Enter a Medicare secondary claim
The following instructions are for entering a claim with Medicare as the secondary payer. For more information on billing...
Contacting the EDI and SPOT customer help desks
Different help desks are available for the different types of electronic billing questions. Carefully consider the type of...