If you did not furnish any covered services to Medicare beneficiaries during the entire cost reporting period, a full cost report is not required. We may authorize less than a full cost report where a provider has had low utilization of covered services by Medicare beneficiaries in a reporting period and received correspondingly low interim reimbursement payments.

If you would like to expedite a request for an extended repayment schedule, please send an email to FCSO-ERS@FCSO.com. You can find the appropriate form and certification on our website by clicking here. In addition, include a copy of the first payment of the check. Mail the check to: 

Checks are to be made payable to First Coast Service Options Inc. They should be annotated with your provider name, number, and cost report year end that applies to the amount due. The original check should not be attached to the cost report but should be mailed to: 

First Coast Service Options Inc.
Medicare Part A Debt Recovery
P.O. Box 3162
Mechanicsburg, PA 17055-1837

First Coast encourages all providers to submit cost reports and supporting documentation electronically whenever possible. In addition to the environmental benefits of this approach, it is also more efficient from a time and cost perspective.

The electronic cost report must be created on CMS-approved cost report software. Submit the electronic cost report, along with supporting documentation, on a CD-ROM (preferred), diskette, or flash drive. When submitting protected health information (PHI), proper steps must be taken to ensure it is encrypted and complies with Federal Information Processing Standards (FIPS) 140-02. First Coast offers the option of filing your cost report via the MCReF (Medicare Cost Report eFiling) portal.

The penalty for not filing the cost report timely is that 100 percent of any payments will be withheld. In addition, providers will be assessed interest at the prevailing rate at the time the cost report is due. Furthermore, if the cost report cannot be submitted by the due date, providers may request a reduced payment suspension rate of 50 percent during a grace period of 60 days. This request should be submitted before the due date of the cost report. On the 61st day, if the cost report has not been filed, the rate of suspension will change to 100 percent.