Additional IVR instructions are available via our IVR Florida Medicare Part B

Part B interactive voice response (IVR) operating guide 1-877-847-4992

First Coast Service Options Inc. (FCSO) strives to provide you with the most up-to-date automation features as possible. The IVR operating guide will help to increase your knowledge of the technology and services we offer our providers.

Hours of operation

IVR unit hours of availability

The IVR is available 24 hours a day, 7 days a week except for regularly scheduled maintenance. However, specific claim and/or eligibility information is available during the following times with the exception of holidays:

Monday-Friday 7:00 a.m. to 6:30 p.m., ET
Saturday 7:00 a.m. to 3:00 p.m., ET

Touchtone or speech

Providers in Florida have the option of selecting speech or touchtone when using the IVR. Touchtone is available to providers in the U.S. Virgin Islands and Puerto Rico. In order to receive the maximum results that you deserve when speaking, we offer the following tips:

• Use a telephone with a handset or headset

• Avoid using a speakerphone or cell phone

• Avoid calling from areas with loud background noise

• Speak the requested information clearly and in a quiet environment

*When using the speech recognition option on the IVR and keying the date is required (date of service, date of birth, etc.), the date must be given in an 8-digit format (mm/dd/yyyy).

In the event the system does not accept the spoken information, touch-tone is always available. In order to receive the maximum results that you deserve when using touch-tone, we offer the following tips:

• Dates should be entered in the following format (mm/dd/yy)

• To signal you are entering an alpha suffix or letter, press the * key

• Press the key that includes the letter, then the corresponding number that denotes where the letter is located on the number key.

• After all letters desired have been keyed, press the pound (#) sign to end your entry.

Use the numbers on the telephone keypad that corresponds to the patient or provider number:

A = *21#

Q =*72#

R = *73#

Z = *94#

Helpful tips

As a result of the Health Insurance Portability and Accountability Act (HIPAA), we are required to protect the privacy of all individuals. You must have the following information available for authentication to access patient eligibility, deductible and claims information via the IVR:

• National Provider Identifier (NPI)

• Tax Identification Number (TIN)

• Provider Transaction Access Number (PTAN)

• Beneficiary Medicare number

• Beneficiary name,

• Beneficiary date of birth

• Date of service (If applicable)

Main menu — number/option

1. Closures. hot topics, outreach events, general questions and hours of operation

2. Status and reopenings

3. Eligibility

4. Pending claims

5. Check status

6. Remittance codes/pricing

7. Enrollment information

Closures and general information – press 1

• Training and holiday closures, press 1

• Hot topics, press 2

• Provider outreach and education information, press 3

• General appeals, website and information to have when calling Medicare, press 4

• Hours of operation, press 5

Claim and correspondence status and telephone reopenings – press 2

• For claim status, press 1

Assigned claim status

Pending, finalized, denied

Date of service

Amount submitted

Processed date

Deductible

Payment amount

Payment date

Check number

Internal Control Number (ICN)

Supplemental insurance (Forwarded or not)

Non – assigned claims

Processed date

Amount submitted

Payment date

• Additional claim detail

*This menu is offered after the information above has been voiced.

• Procedure code

• Date of service

• Billed amount and allowed amount for each procedure code

• Denial message

• For correspondence status, press 2

• IVR will voice date correspondence was completed and the Correspondence Control Number (CCN)

• To request a telephone reopening of a claim, press 3

This option provides callers with the ability to request a telephone reopening on a single detail line of a claim with the exception of hospice and entitlement related services.

Changes to date of service, press 1

To add, delete, or change a modifier, press 2

To change a diagnosis, press 3

Note: This option is only for the primary diagnosis for a procedure.

To have MSP, entitlement and Medicare Advantage claim denials reprocessed, press 4

Eligibility, Medicare Secondary Payer, Medicare Advantage, deductible and physical and occupational therapy information – press 3

• For current eligibility information, press 1

• Entitlement date

• Termination date (if applicable)

• Part B deductible

• Current Year deductible

• Previous Year deductible

• Medicare Advantage information

• Medicare is primary or secondary

If a Medicare Advantage plan is found, you can press 1 for more information.

• Medicare Advantage number

• Plan type

• Plan name

• Effective and termination date of policy

• Address of Medicare Advantage servicing provider

If Medicare is secondary, press 1 for MSP details

• Type of primary insurance

• Effective and termination date for all valid Insurers

• (Current or previous date of service)

• For eligibility for a previous date of service, press 2

• For physical and occupational therapy information, press 3

• For Medicare Advantage Plan information, press 4

• enters a specific Medicare Advantage plan number to receive specific information such as:

• Plan name

• Type of plan

• Address of plan provider

*Note – The Medicare Advantage plan number was formerly known as HMO Plan number.

Note: After primary eligibility information is obtained, the IVR will prompt the caller to press an option for additional eligibility.

Sub menu for additional eligibility menu

• Hospice

• Hospice effective date

• Termination date (if applicable)

• Servicing provider number

• Home health

• Home health effective date

• Termination date (if applicable)

• Servicing provider number

• Skilled nursing facility

• SNF effective date

• Termination date (if Applicable)

• Servicing provider number

Pending claims information and month-to-date or year-to-date dollar amount on file – press 4

• For pending claim information, press 1

• For month or year-to-date dollar amount, press 2

• For the previous year paid amount, press 3

Check information – press 5

• For the last three checks, press 1

• For check history by issue date, press 2

• For check history by check number, press 3

Definitions of remittance codes and pricing for procedure codes – press 6

• For remittance code information, press 1

• For pricing of a procedure code, press 2

Enrollment information – press 7

• For status of an enrollment application, press 1

• For a summary of applications and when to use them, press 2

• For a summary of documents required for certain specialties, press 3

• For mailing address and PECOS Internet enrollment information, press 4

• For open enrollment and participation in Medicare information, press 5

• For a summary of enrollment information available on our website, press 6

Repeat menu – press 8

This option returns callers to the main menu.

End call – press 9

This option ends the call in the IVR.