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New provider roadmap: Electronic data interchange (EDI)

Electronic billing is the single most effective way to become more efficient in your daily business routine with Medicare. Improved cash flow, added security, and reduced administrative costs are just some of the advantages of electronic billing.

Step 1: Choose a method

There are four ways to submit electronic claims. Choose a method of connection:

  • SPOT Portal:
    • Connect to SPOT via the internet
  • Secure file transfer protocol (SFTP):
    • Communication method for delivering and/or receiving data
  • Third party via a billing service or clearinghouse:
    • Third party software which has a connectivity built in
  • Direct data entry (DDE) via the Fiscal Intermediary Shared System (FISS) (Part A Only)

Please read a step-by-step guide to getting started submitting electronic claims for providers.

Step 2: Select software

Software must be downloaded to create the electronic claim file. There are two software options:

  • PC-ACE:
    • Data entry for claims
    • Built in edits
    • Capability to send batches of claims together
  • Vendor's software, billing service or clearinghouse:

Note: If you are submitting through FISS (Part A), additional software is not needed.

Step 3: Complete EDI enrollment form

Complete the EDI enrollment form. The enrollment forms are specific to which method you chose in Step 1.

SPOT Portal

Provider office: EDI SPOT Enrollment Form 

This form should be completed by provider offices who want to enroll in SPOT.

Instructions for completing the EDI SPOT Enrollment Form

Secure file transfer protocol (SFTP)

First Coast EDI Enrollment Form

This form should be completed by providers using SFTP or a third party (billing service/clearinghouse) to submit claims and/or retrieve reports.

This form should also be completed by Part A providers requesting access to FISS. After the 8292 form is completed for the facility, individual office personnel who will need access to FISS must complete the DDE (direct data entry) user ID request form. 

Instructions for completing the 8292 form for providers and third-party organizations

Check status on the EDI enrollment form by emailing EDI, MedicareEDI@FCSO.com, or call the Help Desk for quick response.

Contact EDI

For questions regarding EDI forms or processes, please contact the EDI Help Desk:

888-670-0940

Monday to Friday, 8 a.m. – 5 p.m. (ET)

For questions regarding SPOT, please contact the SPOT Help Desk at 855-416-4199:

Monday- Friday, 8 a.m. - 5 p.m. (ET)

Continue to Claim submission section

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