The Part A “Direct Data Entry (DDE) user ID request form” has been revised. This form is intended for provider use only and replaces previous DDE enrollment forms. Previous forms will not be accepted as of May 4, 2024.
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Medicare participating providers/suppliers in Puerto Rico Part 1 enrolled with First Coast.
Medicare participating providers/suppliers in Puerto Rico Part 2 enrolled with First Coast.
Cost outlier claims timeline example.
Cost outlier claims timeline example.
Cost outlier claims timeline example.
Cost outlier claims timeline example.
Fax / mail coversheet - Prior authorization request for repetitive, scheduled non-emergent ambulance transports (RSNAT)
View this updated prior authorization request coversheet for repetitive, scheduled non-emergent ambulance transport (RSNAT).
Medicare participating providers/suppliers in Florida for Area 1, Part 2 enrolled with First Coast.
Medicare participating providers/suppliers in Florida for Area 2, Part 1 enrolled with First Coast.