Part B

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Determining your Medicare effective date

Use this guide to help determine your Medicare effective date based on your applicable scenario(s).

Submit medical review documentation electronically

Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options…

Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

Checklist: Cardiac defibrillator implant w/o cardiac cath

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac defibrillator implant w/o cardiac cath (DRG 226 and 227) services.

Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

Post-payment service-specific reviews

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.

Stay of enrollment

Update: Providers have reported that stay of enrollment letters have been found in their spam folder when sent via email. Please ensure your spam folder is monitored for any provider enrollment…

Stay of enrollment

Update: Providers have reported that stay of enrollment letters have been found in their spam folder when sent via email. Please ensure your spam folder is monitored for any provider enrollment…

Post-payment service-specific reviews

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.

Determining your Medicare effective date

Use this guide to help determine your Medicare effective date based on your applicable scenario(s).