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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.
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…
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.
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or supplier furnishing the services. Find out the…