First Coast encourages providers to review this fact sheet designed to help providers understand how to provide accurate and supportive medical record documentation.
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.
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…
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
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…