Statewide Healthcare RCM Coverage • 945 Cities & Towns
Medical Billing & RCM Services in Florida
Delivering tailored medical coding, billing, and credentialing services across Florida. Serving healthcare providers, clinics, and hospital groups with an exceptional 98% clean claim rate.
Statewide Regulatory & MAC Compliance Hub
Florida Medicare MAC Jurisdiction & Payer Regulations (J-N)
Comprehensive Part A/B Medicare contractor policies, LCD standards, and state Medicaid filing rules for Florida medical practices.
98.2% First-Pass Clean Claim Rate
Medicare Administrative Contractor (MAC)
J-N
Jurisdiction N (J-N)
Contractor:
First Coast Service Options, Inc. (FCSO) (HQ: Jacksonville, FL)
State Medicaid & Public Health Agency
FL
Florida Agency for Health Care Administration (AHCA / SMMC)
Governing Agency:
Florida Agency for Health Care Administration (AHCA)
Medicaid Timely Filing:
365 days from Date of Service / 90 days from Medicare RA
Medicare Timely Filing Window
12 months (365 days) from Date of Service
First-Level Appeals (Redetermination)
120 calendar days from Remittance Advice (Redetermination)
First-Pass Clean Claim Target
98.2% Scrubber Rate
Active Local Coverage Determinations (LCDs) in Florida (J-N):
4 Active LCDs
L33751
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI / OCT)
L39641
Micro-Invasive Glaucoma Surgery (MIGS)
L33748
Joint Injections & Local Infiltration
L33822
Continuous Glucose Monitors (CGM)
Regional Billing Nuances & Compliance Safeguards:
High-Volume Senior Audit Scrutiny: FCSO enforces rigorous Targeted Probe & Educate (TPE) audits for high-volume Florida geriatric specialties (Ophthalmology, Pain, Dermatology, Cardiology).
Puerto Rico (PR) & Virgin Islands (VI) Operations: Dual-language Spanish/English documentation handling; specific PR locality payment schedules.
Florida Medicaid (AHCA / SMMC): Automatic crossover coordination with Florida Statewide Medicaid Managed Care plans.
Mandatory single-use drug vial wastage recording with JW/JZ modifiers.
Healthcare Locations & Cities in Florida
Select your city below for specialized local medical billing solutions and regional payer expertise.