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Understanding applicable Medicare coverage criteria for medical necessity and documentation guidelines for healthcare services is extremely important for the accurate and timely processing and payment of claims. Partnering with Medicare can…
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in Florida, Puerto Rico and the US Virgin Islands. Learn more about the program and how you can participate.
Continuing Education Units (CEU) certificates may be awarded for successful completion of First Coast’s educational events and will be maintained within our MyCEUCertificate Gateway for two years from the date of the event.
First Coast provider outreach and education advisory groups meet at least three times per year. Meetings may be held online (e.g., webinar) or as a face-to-face event. This schedule lists the meetings planned for Florida, the U.S. Virgin Is…
Each year, First Coast invites members of the provider community to join the provider outreach and education advisory group for their geographic area. This document lists the members of Part A and Part B advisory groups for providers in Flo…
The Provider Outreach and Education team at First Coast welcomes you to Medicare. Providers are responsible for knowing and following the rules and regulations that apply to all services billed to Medicare under their provider number.
Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treat…
First Coast wants you to prevent claim denials or appeals by coding the appropriate number of units correctly the first time.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.