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Section 4507 of the 1997 Balanced Budget Act allows a physician or practitioner to enter a private contract with a Medicare beneficiary.

The CMS sample revalidation letter offers providers the opportunity to see what they can expect to receive when it is time for them to revalidate. Access the revalidation request letter to be prepared for your revalidation.

The CMS sample revalidation letter offers providers the opportunity to see what they can expect to receive when it is time for them to revalidate. Access the stopping billing privileges letter to be prepared for your revalidation.

This SPOT form is for third-party organizations such as clearinghouses and billing services to request access to SPOT.

This form is used by a billing service or clearinghouse to set up previously enrolled providers for SPOT.

Provider and third-party billing agent organizations should use this form to request updates to their SPOT registration, such as changing an approver.

Use this questionnaire for assistance in determining if the referring laboratory may bill for tests performed by a reference laboratory.

To opt-out, eligible practitioners must submit an opt-out affidavit. View this sample form. 

Medicare participating providers/suppliers in Florida for Area 4, Part 2 enrolled with First Coast.

Medicare participating providers/suppliers in Florida for Area 3, Part 1 enrolled with First Coast.