Did you notify Medicare that your address changed? Don’t miss important notifications and ADRs
First Coast sometimes requires a clinical review of documentation to determine the medical necessity of services. Our goal is to ensure that providers are properly reimbursed for medically reasonable and necessary services. When documentation is required, we mail additional development requests (ADRs) to providers.
It is imperative that you confirm the appropriate address is on file to ensure receipt of the ADR. If the letter is not received resulting in the provider not responding to the ADR with medical documentation in the timeframe allowed, the claim will be denied.
What address is used for mailing ADRs?
Part A
In the Fiscal Intermediary Standard System (FISS), the address in the “other address” field is used for mailing correspondence and ADR letters. The “other address” is pulled from the CMS-855A, Section 2C for Correspondence Address. First Coast cannot change the designation for mailing correspondence and ADRs to a different address. If you would like to change the address listed in the “other address” field, you may request a change of information via the CMS-855 enrollment application.
Part B
The ADR letter is mailed to a provider’s practice address on file with Medicare. For individual providers rendering services in large facilities such as hospitals the ADR letter may be misdirected and not received in time by the appropriate department or individual provider.
Providers in these situations may request First Coast to mail all correspondence (including ADRs) to the pay-to address listed on their PECOS file.
How can I request that all correspondence go to my pay-to address?
If the pay-to address is already on file in PECOS:
- Submit a letter on company letterhead requesting all correspondence be sent to the pay-to address on file. The letter must be signed by a person in an official role (authorized or delegated official) for the billing provider.
If the pay-to address is not already on file in PECOS:
- Submit a change of information using the appropriate paper CMS-855 enrollment application or internet-based PECOS to update the pay-to address. Include a letter on company letterhead requesting all correspondence be sent to the pay-to address being updated with the enrollment application. The letter must be signed by a person in an official role (authorized or delegated official) for the billing provider.
Note: Please keep in mind that once completed, ALL system-generated correspondence from First Coast will be sent to this address. This includes situations where the provider has more than one practice location; all correspondence for all practice locations will be sent to the designated pay-to address you selected once First Coast makes the change. We may use other addresses for special mailings that are not system-generated.
The letter and application, if applicable, may be mailed to:
Provider Enrollment
P.O. Box 3409
Mechanicsburg, PA 17055-1849
For more information, see the webpages below: