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Answers

Modified: 4/1/2024
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 3/6/2024
Modified: 3/15/2024
Question relating to CMS guidelines regarding use of ABN in relation to ambulance services.
Modified: 3/22/2024
FAQ regarding signature requirements on ambulance claims
Modified: 3/7/2024
The AMA Levels of Medical Decision Making table indicates *Each unique test, order, or document contributes to the combination of two or combination of three in Category 1. with levels and guidelines for Category 1 as follows:
Modified: 4/1/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/11/2024
Modified: 4/12/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 1/20/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 3/11/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 1/4/2024
Modified: 3/7/2024
This field is not required to use the score sheet. It was added to allow the user to enter the patient name, or any other patient-specific identifying information for printing and/or filing purposes only.
Modified: 1/4/2024
How to access benefits exhaust information in the remittance advice.
Modified: 3/12/2024
Question and answer pertaining to services which can be billed "incident to" another provider's service.
Modified: 4/10/2024
Modified: 2/21/2024
Question and answer pertaining to services which can be billed "incident to" another provider's service.
Modified: 1/8/2024
Question and answer pertaining to the partial hospitalization program for substance use disorder.
Modified: 10/26/2022
Question and answer referencing mailing address for CMS-1500 paper claim form.
Modified: 2/15/2024
Question and answer pertaining to Medicare enrollment applications.
Modified: 2/4/2024
Question and answer pertaining to early offset of a demanded debt.
Modified: 1/28/2024
Modified: 4/16/2024
Modified: 4/10/2024
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 4/3/2024
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 3/26/2024
Modified: 3/11/2024
Question and answer pertaining to entering place of service (POS) codes on claims.
Modified: 3/11/2024
Question and answer regarding the indication of an anti-markup diagnostic service on a claim.
Modified: 3/26/2024
Question and answer pertaining to indicating provider numbers on claims.
Modified: 3/26/2024
Question and answer regarding the indication of rendering physician billing numbers on claims.
Modified: 3/11/2024
Question and answer about reporting service facility location information on a claim.
Modified: 11/15/2023
Modified: 4/9/2024
Modified: 4/10/2024
How to avoid RUCs [First Coast Education Action Team]
Modified: 2/16/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were rejected as unprocessable with tips and resources to help you avoid many of these errors. [First Coast Education Action Team]
Modified: 2/26/2024
Changed dates
Modified: 3/26/2024
Question and answer pertaining to timely filing of claims.
Modified: 3/11/2024
Modified: 3/11/2024
Modified: 12/4/2023
Modified: 3/11/2024
Modified: 12/4/2023
Modified: 3/11/2024
Modified: 3/11/2024
Modified: 1/26/2024
Questions and answers pertaining to ambulance services.
Modified: 1/26/2024
Modified: 4/14/2024
Question and answer regarding denial reason code 54MUE.
Modified: 1/20/2024
Modified: 4/11/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 3/22/2024
[First Coast Education Action Team]
Modified: 3/22/2024
[First Coast Education Action Team]
Modified: 3/22/2024
[First Coast Education Action Team]
Modified: 4/12/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 1/24/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 1/4/2024
Question and answer pertaining to ANSI code OA-18.
Modified: 3/22/2024
[First Coast Education Action Team]
Modified: 4/12/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims denied with tips and resources to help you avoid many of these errors.
Modified: 11/15/2023
Modified: 3/25/2024
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 1/20/2024
Modified: 3/22/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 3/25/2024
Answers to questions pertaining to Part B provider enrollment issues, including application status, electronic funds transfer (EFT), CMS 855 forms, and PECOS.
Modified: 4/9/2024
Modified: 4/16/2024
[CR 6417]
Modified: 4/17/2024
Questions and answers pertaining to the 2% reduction in Medicare payments due to federal sequestration.
Modified: 4/2/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/9/2024
Modified: 4/14/2024
Question and answer pertaining to services which can be billed incident to another provider's service.
Modified: 2/16/2024
Modified: 2/15/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 2/16/2024
Modified: 4/12/2023
return documentation, medical records
Modified: 2/16/2024
Modified: 2/7/2024
Question and answer pertaining to how providers can determine when Medicare is the secondary payer. [CMS website]
Modified: 3/1/2024
TPE selection process
Modified: 3/1/2024
return documentation, medical records
Modified: 2/16/2024
Modified: 2/11/2024
Question and answer pertaining to how Medicare secondary payment is determined.
Modified: 4/8/2024
View this article to see how the error rate is determined.
Modified: 3/1/2024
review results
Modified: 2/16/2024
Modified: 2/23/2024
education call attempts
Modified: 1/25/2024
Modified: 1/26/2024
Modified: 4/12/2024
Answer to the question regarding a timetable for coding inpatient cost outlier claims.
Modified: 2/16/2024
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 3/22/2024
Answers to questions pertaining to registering and joining a webinar, accessing the handouts and downloading the certificate of completion.
Modified: 1/26/2024
Question regarding changes made to consolidated billing for ambulance transport for skilled nursing facility residents according to transmittal MM10550.
Modified: 4/9/2024
Modified: 1/13/2024
Questions and answers pertaining to Medicare secondary payer claims.
Modified: 11/13/2023
Questions and answers pertaining to specific modifiers.
Modified: 11/13/2023
Questions and answers pertaining to specific modifiers.
Modified: 4/8/2024
Questions and answers pertaining to specific modifiers.
Modified: 3/4/2024
Modified: 4/3/2024
Modified: 3/22/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 3/7/2024
The worksheet will only provide a suggested code for the E/M level of service. A note will populate alerting you that the service may qualify for additional prolonged services with a link to the prolonged service information.
Modified: 4/16/2024
Question and answer pertaining to providers that need to enroll in a different state using Internet-based PECOS.
Modified: 4/3/2024
Modified: 4/4/2024
The Provider Contact Center is receiving inquiries regarding claims rejected because of the ZIP code that does not match the PECOS file. This FAQ shows how to avoid and correct this error.
Modified: 3/19/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 3/12/2024
Modified: 3/19/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 11/15/2023
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 3/19/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 7/19/2023
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims. [First Coast's Education Action Team]
Modified: 11/15/2023
[First Coast Provider Outreach and Education]
Modified: 4/10/2024
Modified: 1/13/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 4/1/2024
Question and answer pertaining to CARC CO 144.
Modified: 1/13/2024
When responding to a CERT request for medical records, can records from a referring or consulting physician be included? [First Coast Provider Outreach and Education]
Modified: 4/12/2024
Modified: 3/5/2024
Revised, no comments
Modified: 1/11/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 1/11/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 3/19/2024
To help you increase the number of claims that pass through edits and into processing, here are the top reasons for rejected claims as well as tips and resources to help you avoid many of these errors.
Modified: 4/9/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 1/24/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 4/9/2024
Questions and answers pertaining to hospice.
Modified: 4/9/2024
Questions and answers pertaining to verifying beneficiary eligibility.
Modified: 4/12/2024
Question and answer pertaining to Medicare enrollment applications.
Modified: 2/19/2024
Modified: 3/19/2024
Modified: 4/11/2024
Questions and answers pertaining to operating physician’s NPI was missing.
Modified: 1/20/2024
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Modified: 1/20/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 1/20/2024
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons claims were returned as unprocessable (RUC) with tips and resources to help you avoid many of these errors.
Modified: 4/11/2024
Question and answer cost outlier claims.
Modified: 1/26/2024
Modified: 3/7/2024
Modified: 4/14/2024
Modified: 4/3/2024
Modified: 4/3/2024
Modified: 3/7/2024
It is suggested to score both the time and medical decision making to allow billing of the highest scoring component.
Modified: 3/7/2024
The worksheet allows for multiple start and end times to be entered. The worksheet will calculate the total time. Be sure to click “add” to enter multiple start and end times.
Modified: 3/7/2024
The office/outpatient scoring allows you to enter the total time or start and end times.
Modified: 12/4/2023
Modified: 4/17/2024
Read this article for instructions on how to terminate your Medicare enrollment.
Modified: 2/26/2024
Question and answer pertaining to what actions providers take to appeal an overpayment for an MSP claim and stop the AR offset.
Modified: 2/7/2024
Question and answer pertaining to a duplicate primary payment.
Modified: 2/7/2024
Question and answer pertaining to an overpaid claim.
Modified: 1/31/2024
Question and answer pertaining to receiving an overpayment letter.
Modified: 1/28/2024
Question and answer pertaining to what form providers use to notify Medicare of a MSP overpayment.
Modified: 2/9/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 2/4/2024
Question and answer pertaining to a redetermination or reconsideration appeal requested.
Modified: 3/15/2024
TPE appeals
Modified: 3/15/2024
Modified: 1/28/2024
Question and answer pertaining to what if an MSP refund is made but the other insurer’s EOB is not sent with the payment.
Modified: 2/7/2024
Question and answer pertaining to what providers must do when refund is not made when notifying Medicare of a DPP.
Modified: 1/31/2024
Question and answer pertaining to an overpayment refund that cannot be made at one time.
Modified: 2/7/2024
Question and answer pertaining to what MSP is.
Modified: 2/16/2024
Modified: 2/16/2024
Modified: 1/28/2024
Question and answer pertaining to what providers must do when a duplicate primary payment is received.
Modified: 4/3/2024
Modified: 2/16/2024
Modified: 3/1/2024
resources, policies, references
Modified: 4/11/2024
Question and answer to cost outlier claims.
Modified: 4/11/2024
Answer to the question of when OSC 70 should be used for cost outlier claims.
Modified: 4/8/2024
LCD, NCD
Modified: 4/1/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 1/25/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/12/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/12/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 2/16/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/12/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/17/2024
Questions and answers pertaining to Medicare fee schedules and fee schedule-related issues.
Modified: 4/8/2024
additional documentation request
Modified: 3/31/2024
Question and answer regarding the indication of referring provider information on claims.
Modified: 2/4/2024
Question and answer pertaining to what the MSP Contractor is, formally known as BCRC.
Modified: 3/2/2024
The icons are clickable informational links to assist you with understanding the term used in the score sheet.
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.