Submit Part B claims and correct claims billed in error electronically
Are you using regular mail for submissions to First Coast? We have several electronic options that are easier and faster for you to use. Additionally, submitting documentation electronically:
- Saves time, electronic submission eliminates mailing delays
- Eliminates administrative costs, electronic submission costs nothing
- Protects patient information, electronic submission is secure
- Allows for the immediate confirmation of receipt, electronic submission provides transaction confirmations
Read on to find out how you can avoid the wait by submitting electronically.
What are you trying to submit to First Coast?
Submitting a claim electronically
CMS requires providers to submit their claims electronically. Please see the CMS IOM Pub. 100-04 Claims Processing Manual, Chapter 24, section 90 concerning the mandatory requirement for electronic claims submission.
If you want to ease into electronic billing, First Coast offers the following software programs:
| Electronic submission method | Submission instructions | Additional resources |
|---|---|---|
| PC-ACE | Refer to PC-ACE software for technical requirements, enrollment, software installation, claim entry and transmission instructions. | |
| Billing service / clearinghouse |
Third-party billing service or clearinghouse submitting claims on behalf of provider. Refer to Provider guidelines for choosing a vendor for further assistance. |
Visit our Approved vendor list for further information. |
Correcting a claim billed in error
Claims billed in error may be corrected electronically using SPOT or the Reopening Gateway. Use the Billed in Error feature to report paid claims, or individual lines of a claim, as billed in error. The claim must finalize prior to reporting the claim or line item(s) as billed in error.
| Electronic submission method | Submission instructions | Additional resources |
|---|---|---|
| SPOT | To perform a claim correction using SPOT, select the Reopening/correct a claim option from the Appeals option on the SPOT toolbar. Then select Overpayment correction. |
To learn more and enroll for SPOT, view: |
| Reopening Gateway |
The Reopening Gateway is a free self-service tool that does not require enrollment:
|
To learn more, visit the Reopening Gateway and the help guide. |
First Coast offers free education on the submission methods described above. Access the following to learn more:
Back to the Avoid the wait home page to explore more topics and options for electronic submission: