Application status lookup tool

Posted by:  :  Category: Medicare

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.

How to complete the EDI enrollment form

The Electronic Data Interchange (EDI) enrollment form is an interactive form to be completed on-screen. After completion this form can be printed for signatures then faxing or mailed. This interactive for now allows an authorized electronic signature and can be emailed. Please see guidelines of authorized signature further in these instructions. This form is intended for provider use only and only the owner of the NPI/PTAN may inquire the status of the application.

Beneficiary Eligibility Denials

Denial Reason, Reason/Remark Code(s) PR-26: Expenses incurred prior to coverage PR-27: Expenses incurred after coverage terminated Resolution/Resources: Verify patient eligibility prior to submitting claims to Medicare through the Palmetto GBA Online Provider Services (OPS) tool or Interactive Voice Response (IVR) unit. We have to check the eligibility information through the insurance website or by calling the payer. Once we got the information we have to check the billed Date Of Service, if it prior or after the coverage then we can very well go ahead and bill the patient without any hesitation. Online Eligibility Verification through eServices All providers that have an EDI Enrollment Agreement on file may register to use this tool. If you haven’t already registered, please consider doing so. Please note: Only one provider administrator per EDI Enrollment Agreement/per PTAN/NPI combination performs the registration process. The provider administrator can then grant permission to additional users related to that PTAN/NPI. Online Eligibility Verification through OPS

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