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Claims & EDI

April 1, 2026

New provider roadmap: Claims submission

April 6, 2026
Once enrolled as a Medicare provider, a billing method with Medicare needs to be established. Step 1: Choose your billing method

Prevent errors on your OTP claims

April 6, 2026
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.

Submitting high dollar claims for single use vials

April 7, 2026
Read this article to learn more about submitting high dollar claims for single use vials.

Method II critical access hospitals: Reprocessing certain claims with reassigned billing rights

April 8, 2026
Breaking news for critical access hospitals (CAHs): CMS has directed MACs to immediately turn off reason codes 31006 and 31007 to give providers time to submit all method II reassignments to their Part A CAHs promptly. Read further to learn…

Critical access hospital (CAH) method II professional reassignments

April 8, 2026
CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment isn’t in PECOS. Watch the on-demand learning video, "CAHs Method II Professional Reassignments," for instructions to add reassignments.

Institutional billing resources (Addendums A, B, D1 and E*)

April 9, 2026
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.

Resolving claims overlapping a skilled nursing facility (SNF) stay

April 13, 2026
Is your facility receiving denials for a claim overlapping a skilled nursing facility (SNF) stay? Claims overlapping with a skilled nursing facility (SNF) stay can occur for several reasons. This article is intended to assist providers with…

Hospice: New requirement for physicians who certify patient eligibility

April 15, 2026
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or later.

Ambulance modifiers

February 16, 2026
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.
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