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The SPOT User Guide: Section 1 - Introduction

First Coast’s Secure Provider Online Tool (SPOT)

First Coast developed its provider internet portal application - SPOT - to offer secure, online access to Medicare data, including claim status, payment information, benefits / eligibility, and data reports for members of its provider community in Florida, Puerto Rico, and the U.S. Virgin Islands. 

SPOT is also an alternative channel for the electronic submission of various forms through Secure Documentation.

SPOT is a web-based application (https://thespot.fcso.com) hosted by CMS’ Identity Management (IDM) system.

Note: The use of First Coast’s provider internet portal is not required and is at the discretion of the user in accordance with guidelines established by CMS.

Portal access

  • Registered users may access Medicare data through the portal free-of-charge.
  • Part A Military Treatment Facilities (MTFs) will only have access to eligibility, MBI lookup, claim status, and remittance advice.
  • To protect proprietary and beneficiary data, users are prompted with a session timeout warning message after 20 minutes of inactivity. If there are no responses to the session timeout warning, users will automatically be logged out after the session limit expires at 30 minutes. There are no limitations to periods of active use.

Accessibility information

SPOT has been carefully designed with various accessibility options to allow use by all individuals. These options include the ability to:   

  • Change the font size without sacrificing usability.
  • Navigate the application using just a keyboard (with the use of assistive software such as JAWS).
  • Listen to most of the website and the user guide using a screen reader (with the use of assistive software such as JAWS).

Scope 

The SPOT: User Guide furnishes procedural information and representative screen prints that are common to most users. On-screen help and contextual error messages will help guide users when completing procedures not illustrated in this manual. 

Conventions

The SPOT: User Guide provides procedural information and representative screen prints, as appropriate, to describe how users may access and utilize the features of SPOT. 

The following conventions will be utilized in this manual:

  • Navigation labels will be presented in bold (e.g., Claims, Eligibility, Appeals).
  • Labels of entry fields, buttons, or menus (e.g., Submit button, Medicare ID,) that require user interaction (e.g., Click, Enter, Select) will be presented in bold in the action statement; links to be acted upon are indicated as links in blue text in the action statement.
  • Hyperlink labels will be presented as blue text in the action statement.

Note: The term “user” is used throughout this document to refer to an individual who requires and/or has acquired access to SPOT. 

Limitations

SPOT has the following system limitations:

  • As a web-based application, users of the SPOT must have internet access.
  • Access to SPOT is dependent upon the availability of IDM.
  • Access to Medicare data through the SPOT is dependent upon the availability of CMS’ systems (i.e., IDM, FISS, MCS, PECOS, HETS, HIGLAS, MAS, and SAS).
  • Access to previous queries submitted through the SPOT is limited to each individual session.
  • SPOT may only display claims status information and payment information related to claims that have been processed by First Coast.
  • The availability of the SPOT may be adversely affected by weather-related events that could disrupt business and access to necessary servers.
  • The availability of the SPOT may be adversely affected by high transaction volumes or simultaneous access by multiple users that exceed system’s load limitations.
  • The availability of the SPOT may be adversely affected by system intrusions or unauthorized access (e.g., hackers) to system resources.
  • The availability of the SPOT may be compromised by the insertion of malicious code, software, or modifications, which could result in portal unavailability.
  • The availability of the SPOT or access to required resources may be adversely affected by routine or unscheduled maintenance.
  • The availability of the SPOT or access to required data systems may be limited due to business operating hours and holidays.
  • Data updates to the SPOT application occur between 6-7:30 a.m. ET each weekday. Users may experience slower response times to claim and payment data queries or an interruption in access during these time periods.

SPOT is available 24/7, apart from routine weekly maintenance (Wednesday 8-10 p.m.) and scheduled outages to maintain performance and allow for functionality updates. During weekly maintenance and scheduled outages, access to SPOT may be unavailable. Access the SPOT system status and scheduled maintenance page for the most up-to-date system status. 

System requirements

SPOT website is optimized for the following operating systems and browsers:

  • Operating system:
    • Windows Vista (or later)
    • MAC OSx v10.8 (or later)
  • Screen resolution: 1024 x 768 or higher

  • Internet browsers: 

    • Microsoft Edge
    • Firefox v31 (or later)
    • Chrome v35 (or later)
    • Safari v6.1 (or later)

    Note: SPOT will automatically determine if your browser meets the minimum requirements 

  • Plug-ins: Verify that you have the latest versions of JAVA and ActiveX
  • Pop-up blockers: Disable pop-up blockers prior to access

File upload requirements

All files uploaded through SPOT must meet the following requirements:

  • File name may not exceed 80 characters
  • File name may only contain numbers, letters, underscore ( _ ), hyphen ( - ), and/or spaces
  • Individual file size may not exceed 50 MB
  • Total submission size may not exceed 200 MB
  • Password protected files are not allowed.

Integration with CMS’ IDM system

To mitigate risk to all stakeholders, access to SPOT requires the existence of an IDM account and a registration process to request access to the portal application. Although users do not need a separate IDM account for each application, they must request access to each application separately.

Acceptance of IDM Terms and Conditions 

Users of U.S. government computer systems must be aware of warnings regarding unauthorized access to those systems, computer usage and monitoring, and local system requirements. 

  • Required before registration
  • Required before logon

Compliance with federal regulations

The sensitivity of Medicare data, combined with increased accessibility to claims, eligibility, and benefit information poses potential security risks to CMS, Medicare administrative contractors (MAC), and beneficiaries. 

Therefore, First Coast’s provider internet portal is designed to ensure compliance with all federal legislation, including the Health Insurance Portability and Accountability Act (HIPAA), federal standards published by the National Institute of Standards and Technology (NIST), and CMS’ policies established to control risk.

SPOT is one of several web-based applications hosted through CMS’ IDM system. 

Acronyms

Acronym Definition
ADR Additional Development Response 
APC Ambulatory Payment Classification
API Application Program Interface
ARS Acceptable Risk Safeguards
CAS Client Automated System
CMS Centers for Medicare & Medicaid Services
CWF Common Working File
DOEBA Date of earliest billing activity
E&M Evaluation and Management
EDI Electronic Data Interchange
ESRD End-stage renal disease
FCSO First Coast Service Options Inc.
FFS Fee-for service
FISS Fiscal Intermediary Standard (or Shared) System
FR Functional Requirement
HETS HIPAA Eligibility Transaction System
HHA Home health agency
HHEH Home Health Episode History (HHEH)
HHS The Department of Health and Human Services
JSM / TDL Joint Signature Memorandum / Technical Design Letter
MA Medicare Advantage
MAC Medicare administrative contractor (MAC)
MCARE Medicare Customer Assistance Regarding Eligibility
MCS Multi-Carrier System
NPI National Provider Identifier
NR Nonfunctional Requirement
PECOS Provider Enrollment Chain and Ownership System 
PHI Protected Health Information (PHI)
PII Personally Identifiable Information (PII)
PMP Project Management Plan
POS Point of Service
PPA Project Process Agreement
PTAN Provider Transaction Access Number
RUG Resource Utilization Group
SAS Statistical Analysis Software
SDMP System Development Management Plan
SNF Skilled Nursing Facility
SOW Statement of Work
SSN Social Security Number
SPOT Secure Provider Online Tool
TIN Tax Identification Number

Glossary

The following definitions are provided for terms used in this manual as well as relevant cross-reference to additional terms that associated with those definitions:

Term Definition
Beneficiary A person who has health care insurance through the Medicare or Medicaid programs.
CMS The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for administering the Medicare program as well as parts of Medicaid.
Date of service Date service was provided to beneficiary
DOEBA Date of the earliest billing activity on record
DOLBA Date of the latest billing activity on record
FCSO First Coast Service Options Inc. (First Coast) is the MAC responsible for processing Part A and Part B Medicare claims for providers and suppliers in Florida, Puerto Rico, and the U.S. Virgin Islands. 
HETS-UI HIPAA Eligibility Transaction System User Interface (HETS-UI) is a HIPAA-compliant, web-based application that furnishes beneficiary eligibility / benefit data (obtained from CMS’ beneficiary eligibility databases) for providers.
HHS The Department of Health and Human Services (HHS) is the federal agency responsible for overseeing the administration of Medicare, Medicaid, and Children's Health Insurance Programs.
Lifetime reserve days The additional days that Medicare covers when a beneficiary is in a hospital for more than 90 days. Beneficiaries have a total of 60 reserve days that may be used during his or her lifetime. 
MAC Medicare administrative contractor (MAC) is a privately owned company that contracts with Medicare to manage the processing of Medicare claims in its assigned jurisdiction.
Medicare ID Medicare ID numbers are used to identify specific individuals within the Medicare system to ensure that all information and claims for that person are recorded and billed to the correct account. 
MM/DD/YYYY Month, Day, Year format (e.g., 01-02-2012)
PDS The Provider Data Summary (PDS) is a report that allows providers to identify recurring billing issues through a detailed analysis of personal billing patterns in comparison with those of similar provider types (during a specified time period). 
Peer group A group of providers that either use the same type of bill (e.g., 76x) or belong to the same specialty
PHI Protected Health Information (PHI) refers to information about health status, provision of health care, or payment for health care that may be linked to a specific individual
PII Personally Identifiable Information (PII) refers to information that may be used to distinguish or trace an individual’s identity (e.g., name, Social Security number) when used alone or in combination with other personal information (e.g., date of birth).
Plan coverage Information regarding the beneficiary’s enrollment under MA and Part D contracts and/or MA Managed Care Plans (Part C contracts) that provide Part A and B benefits for beneficiaries enrolled under a contract.
SPOT Secure Provider Online Tool (SPOT) is First Coast’s provider internet portal / web-based application, which offers access to essential Medicare information, including claim status, beneficiary eligibility and benefits information, payment history, and data reports.
User In the context of this manual, a user is an individual who requires and/or has acquired access to First Coast’s Secure Provider Online Tool (SPOT).

Printing in SPOT 

Select the “PDF” icon on the screen you would like to print. This opens a PDF of all information. You will need Adobe Acrobat Reader software. Once the PDF document is open, you may print to your local printer.

If the “PDF” icon is not available on your screen you will need to perform a browser print by clicking “File, Print” on your browser toolbar.