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Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
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This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit Medicare.gov or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
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Last Modified: 11/11/2020 Location: FL, PR, USVI Business: Part A, Part B

What is post-payment service-specific review FAQ

Q. What is post-payment service-specific review?
A. A post-payment review is conducted on services/claims that have already been submitted and paid by Medicare to the provider. First Coast is required to review documentation that substantiates information reported on claims submitted for reimbursement. We do this to ensure that the Medicare program reimburses only for covered, medically necessary, items or services furnished to eligible beneficiaries by qualified providers or suppliers. The Medical Affairs department will be looking at services/items that are known to be frequently not billed and coded correctly per the Medicare guidelines through post-payment service specific reviews. If during the review we determine that a payment error was made, the provider will be responsible for any overpayment determined during review.
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.