To access the status of a claim or a beneficiary's Medicare eligibility information (including the date of birth, date of death, entitlement dates, benefit dates, deductible, or coinsurance) use these options below.

Prior to providing services, obtain a copy of the beneficiary's Medicare card and verify the beneficiary's insurance information with either the beneficiary or their legal representative. 

Eligibility information through SPOT

First Coast offers such access through SPOT. With SPOT, providers may access Part A and Part B eligibility status as well as benefit eligibility for preventive services, deductibles, therapy caps, inpatient, hospice and home health, Medicare secondary payer (MSP), plan coverage data categories and claim status up to twelve months from the date of the inquiry.

Other options for determining beneficiary eligibility

Part A providers

• Contact the Part A interactive voice response (IVR) system at 877-602-8816.
• 270/271 eligibility transactions -- this is also a real time inquiry, and you can obtain the eligibility information in a batch format for several beneficiaries.

Part B providers

• Contact the Part B IVR at 877-847-4992.

Note: Customer service representatives cannot assist you with eligibility information and are required, by CMS, to refer you to the IVR. The IVR can access information up to 27 months from the date of the inquiry.

Source: CMS IOM Pub. 100-09 MAC Beneficiary and Provider Communications Manual, chapter 6, section 50.1