skip to content
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.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
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 or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 6/14/2022 Location: FL, PR, USVI Business: Part A

Claims overlap FAQ -- Steps to identify impacted claims

Q: What steps can be taken to identify claims that overlap with another provider?
A: If you receive an overlap reason code, you can do one of the following:
Verify your claims submitted through direct data entry (DDE) pdf file
Option -1 (inquiry menu), then option -12 (claims summary), and key in the patient’s Medicare number, your provider number, and press enter
Review the list of claims submitted to identify those with identical dates of service, and validate they were submitted accurately
Verify eligibility for home health episodes and hospice election from the ELGA and/or ELGH screens
Verify the beneficiary/eligibility tab submenu on SPOT
Home health episode start and end date, and the servicing provider’s NPI
Hospice election effective and termination date, revocation code and the servicing provider’s NPI
Review SPOT user resources to learn more about SPOT
NPI registry lookup external link enables you to search for the provider’s information
Verify additional eligibility information from the submenu on the interactive voice response (IVR)
Hospice effective and termination dates (if applicable), and the servicing provider’s ID
Home health effective and termination dates (if applicable), and the servicing provider’s ID
Skilled nursing facility (SNF) effective and termination dates (if applicable), and the servicing provider’s ID
Review the IVR operating guide
Review IVR resources for listings with hospice, home health, and SNF providers, and IDs and addresses
Refer to resolution tips for overlapping claims, which is the A/B and home health and hospice (HHH) MAC collaborative job aid on how to resolve and prevent overlapping claim situations.
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.