Last Modified: 1/8/2025
Location: FL, PR, USVI
Business: Part A
Q1. Is it necessary to complete the Medicare credit balance report certification if we do not have any credit balances to report?
A1. No. Starting December 1, 2024, providers aren't required to submit credit balance reports (CMS-838) on a quarterly basis.
Q2. I adjusted my outstanding credit balance, but the adjustment has not processed by the end of the quarter. Do I include this on my credit balance report?
A2. Yes. If you cannot get your adjustments to finalize timely, you should submit a CMS-838 Credit Balance Report for the corresponding quarter.
Q3. Are there instructions for completing the credit balance report?
Q4. If we choose to repay the credit balance by check, to whom should it be made payable and where should it be mailed?
A4. You must use this address when repaying your credit balance by check. Please be sure to include your Medicare credit balance report certification page, your completed CMS 838, and any additional documentation along with your check.
Mail to:
First Coast Service Options
Attn: Cashier
P.O. Box 3162
Mechanicsburg, PA 17055-1837
Q5. Where do we send reports using other payment types?
A5. You can fax reports using other payment types to 904-361-0359 or submit through SPOT's secure documentation feature.
Q6. How can we verify receipt of our reports?
A6. You can easily verify receipt of your report by using the
credit balance status tool available on our website. By simply keying your provider transaction access number and the corresponding quarter in mm/dd/yyyy format, results display the status of your report. Please allow time for us to receive and manually enter your reports into our database before emailing credit balance inquiries at
JNCreditbalanceinquiries@fcso.com or re-faxing your reports.
Q7. What happens if the credit balance status tool says our report wasn't received?
A7. It may take up to 10 days for credits to show in the credit balance status tool, as these are manually entered into our database. If you've waited the time indicated and your report is still not found on the tool, it is possible your report was rejected.
The credit balance status tool will provide the date your report was received, the dollars associated with Part A and Part B if credits were reported, and whether the report is open or closed. If the status is 'open', your report is in the queue to be processed. If the status is 'closed', your report has already been processed.
Q8. Why would my report be rejected?
A8. There are numerous reasons why reports are rejected. One reason for rejections is when an 838-certification page is incomplete or invalid. Please make sure you're using the following when completing your certification:
• The correct version of the CMS-838 Certification Page/Detail Page. Please use the correct version of the CMS-838 Credit Balance Report. You can type directly into this version which is strongly encouraged to ensure your report is legible. Once completed in full, the report should be printed for signatures.
• 6-digit provider number (do not use NPI or the dash)
• The appropriate quarter ending date (must be in mm/dd/yyyy format and must be either 03/31/20xx, 06/30/20xx, 09/30/20xx, or 12/31/20xx)
• Signature is required
• Block must be checked (check only one block)
• If no credits to report, check either the first or third block. Check the second block only when credits are reported.
• If your certification page meets all the requirements, your report can still reject if you reported credits.
• The detail page(s) must be completed in full.
• All header information must be completed, including the provider number, quarter ending, Part A or B, and contact information for the person we can reach if questions arise.
• Blocks 1-15 should be completed in full, including the beneficiary’s name, Medicare Beneficiary Identifier (MBI) number, and ICN.
Here are some of the reasons why reports containing detail pages are rejected:
• Invalid type of bill (block 4)
• Missing admin / discharge / pay dates (blocks 5-7)
• Amount of credit balance (block 9)
• Method of payment (block 11)
• "X" is used if you've initiated the adjustment, but it didn't finalize before the end of the quarter.
• "A" is used if the adjustment wasn't initiated and a corrected UB-04 is required to be submitted with your report.
• "C" is used if you're submitting a check with your submission. Reports with checks must be mailed to the physical address and the check must accompany your report. Copies of the report must not be faxed!
Reason for credit balance (block 13) (numeric only).
• "1" indicates a duplicate.
• "2" indicates MSP, therefore, in addition to indicating a 2 in block 13, blocks 14 and 15 must be completed.
• "3" indicates 'other' (nothing goes in block 14; block 15 can be completed with comments, but comments are not necessary).
• Value code (block 14). Complete ONLY when MSP is reported in block 13.
• Primary payer (block 15). Complete ONLY when MSP is reported. However, comments can be added when explaining "3" as the reason for credit balance.
Q9. How are we notified if our report was rejected?
A9. Only in cases where you've submitted reports containing credits will you receive a call regarding a rejected report.
Q10. Where do I send my corrected report?
A10. You may fax your corrected report, in its entirety, to 904-361-0359 (do not mail) or through SPOT's secure documentation feature.
Q11. Where can I find valuable information on credit balance reporting?
A11. Everything you need to file your credit balance report can be found on the credit balance reporting page of our website. This page includes links to quarterly updates, the official version of the CMS-838 Credit Balance Report and instructions on how to complete the report, and an excel version of the detail page. Additionally, you will find the fax number and mailing address for check submissions, as well as link to our FAQ document.
Q12. Who do I contact if I have questions about my reports?
Q13. How long must we submit credit balance reports after an affiliated facility is no longer a Medicare facility (i.e., SNF closed and officially tied-out of Medicare program)?
A13. Once a facility closes its doors and notifies their Medicare administrative contractor that they are no longer in operation, following an official ‘tie-out’ process, the facility is no longer required to file credit balance reports.
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.