Medical billing services in Florida
Billing, coding, credentialing and A/R follow-up for providers in Florida.
Billing in Florida: what is different
Nearly all Florida Medicaid members are in Statewide Medicaid Managed Care plans, each with its own authorization rules.
Key payers and contractors in Florida
- Medicare Part A/B
- First Coast Service Options, Jurisdiction JNPortal: SPOT (Secure Provider Online Tool)
- Medicare DME
- CGS, DME MAC Jurisdiction CDME supplier claims only · Portal: myCGS
- Medicaid
- Florida Medicaid (Statewide Medicaid Managed Care)
- Blue Cross Blue Shield
- Florida Blue
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Florida providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with First Coast Service Options through SPOT (Secure Provider Online Tool)
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Florida: common questions
Do you bill Florida Medicaid and its managed care plans?
Yes. We bill Florida Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Florida?
Medicare Part A and B claims in Florida are processed by First Coast Service Options (Jurisdiction JN), and we submit and track them through SPOT (Secure Provider Online Tool). DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction C), through myCGS.
Can you credential new providers in Florida?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Florida.
Neighboring states and key payers
Get a free billing audit for your Florida practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.