September 28, 2007
Welcome New Providers
Welcome to the First Coast Service Options, Inc., family of Medicare providers. 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.
to determine which provider enrollment application you need to submit to enroll in the Medicare Program.Go here to download enrollment applications directly from the Centers for Medicare & Medicaid Services’ Web site.
to download enrollment applications directly from the Centers for Medicare & Medicaid Services’ Web site.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
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.
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.
to use the interactive CMS-855B formCMS-855I
CMS-855R
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.
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.
to watch this simulation on areas of the CMS-1500 form where most submission errors occur.Where do I submit my provider enrollment documentation?
First Coast Service Options, Inc.
P.O. Box 45010
Jacksonville, Florida 32232-5010
