New Providers

September 28, 2007

Welcome New Providers

Welcome to the First Coast Service Options, Inc., family of Medicare providers. FCSO has been the Medicare administrator in Florida for more than 40 years. We are one of the nation’s largest Medicare administrators, and proudly serve more than three million beneficiaries and the health care providers who care for them.

As a new provider to the Medicare program, our goal is to help guide you through your enrollment process. To get you started, we have provided several links below to the critical information and education tools you will need to accurately complete the application process.

Which Enrollment Form Do I Choose?

Go here

to determine which provider enrollment application you need to submit to enroll in the Medicare Program.

How do I complete a CMS-855 form?

The following links will provide you with tools, tips, and step-by-step directions to completing the myriad of CMS-855 forms to help ensure your application processes successfully the first time.

General

• Go here for helpful tips on completing all CMS-855 forms

CMS-855A

• Go here

to view a simulation on how to complete the CMS-855A form

• Go here

to complete the interactive CMS-855A form. Once completed, print it and submit it.

CMS-855B

• Go here

to view how you can avoid the errors that result in the CMS-855B form not being processed, specifically missing signatures or dates in Section 15B and Section 16A.

• Go here

to complete the interactive CMS-855B form. Once completed, print it and submit it.

CMS-855I

• Go here for step-by-step directions to completing the CMS-855I form

• Go here

to complete the interactive CMS-855I form. Once completed, print it and submit it.

CMS-855R

• Go here for step-by-step guidance to completing the CMS-855R form

• Go here

to see a simulation on how to avoid the No. 1 reason applications are denied

• Go here

to complete the interactive CMS-855R form. Once completed, print it and submit it.

Electronic Funds Transfer

• Go here

to find out the advantages of Electronic Funds Transfer (EFT), and the most common problem seen with the EFT application.

CMS-1500 Form

• Go here

to watch this simulation on areas of the CMS-1500 form where most submission errors occur.

Where do I submit my provider enrollment documentation?

Medicare Provider Enrollment (Florida Part A)

First Coast Service Options, Inc.

P.O. Box 45169

Jacksonville, FL 32232-5169

Medicare Provider Enrollment (Florida Part B)

First Coast Service Options, Inc.

P.O. Box 44021

Jacksonville, FL 32231-4021