Billing
Prohibition on billing dually eligible individuals enrolled in the Qualified Medicare Beneficiary (QMB) program
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Medicare secondary payer (MSP): Medicare as the tertiary payer
Read this article for information on how to submit your Part B claim when more than one insurance is primary to Medicare.
Medicare secondary payer (MSP): Medicare as the tertiary payer
Read this article for billing guidelines when Medicare is the tertiary payer.
Quick reference chart for Medicare Secondary Payer (MSP) claims
Review this chart for information on submitting accurate MSP claims.
2026 - 2027 influenza, pneumococcal, and hepatitis B vaccine reimbursement
Review this article for the payment allowances and effective dates for the 2026-2027 flu season.
E/M: Reviewing amount and/or complexity of data
For the element of medical decision making addressing the amount and/or complexity of data to be reviewed and analyzed, the AMA Levels of Medical Decision Making table indicates: "Each unique test,…
E/M: Reviewing amount and/or complexity of data
For the element of medical decision making addressing the amount and/or complexity of data to be reviewed and analyzed, the AMA Levels of Medical Decision Making table indicates: "Each unique test,…
Notify First Coast if you file bankruptcy
First Coast will coordinate with both CMS, and the Department of Justice (DOJ), to assure that we handle your bankruptcy case properly.
Allowing electronic submission of medically denied cancel claims, reason code 30941
To determine if a claim was medically reviewed, providers should submit the requests correctly.
Notify First Coast if you file bankruptcy
First Coast will coordinate with both CMS, and the Department of Justice (DOJ), to assure that we handle your bankruptcy case properly.