J9 First Coast: Puerto Rico Medicare
First Coast Service Options Inc. (First Coast) administers Medicare health insurance for the Centers for Medicare & Medicaid Services (CMS) for Jurisdiction 9 which includes the State of Puerto Rico. If you are a provider located in the State of Puerto Rico and need to become an electronic submitter for your Medicare A/B Claims, please follow the enrollment instructions below.
Required Documents for those applying for new Submitter ID's.
The following documents are required enrollment documents that must be completed, signed and returned to the First Coast office prior to initiation of electronic claims submission or inquiry.
1. EDI Enrollment Form with Instructions
2. Electronic Data Request (EDR) Form
To obtain the forms above, please copy the link below into a new tab or browser, and select your state and line of business:
If you have any questions regarding any of the documents in this package, please call First Coast EDI Technology Support Center at 1-888-875-9779.
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
Our Vendor Information
|Vendor Name - AXIOM Systems, Inc|
|Contact - EDI Team|
|Vendor Code - N/A|
|Phone - 602-439-2525|
|Fax - 602-439-0808|
|Address - 241 East 4th Street, Suite 200|
Frederick, MD 21701
|Software Name- SolAce EMC|
|Email - Support@SolAce-emc.com|
EDI Enrollment Form
Please complete Section C of this form.
- Enter your Business/Practice name or Provider name.
- Organization and Group Practices may leave the "Title" line blank.
- Complete your Address information.
- Sign the name of the person completing the form in the "By" line. Also print their name, title, and enter today's date.
- Enter email address of provider's office contact person to receive approval letter.
- New applicants may leave the "Sender Number" blank.
- Please enter the name and number for the main contact person for your office.
- If you are using a Billing Service, please mark the Billing Service box and enter the Billing Service name.
- Select the type of claims you will be submitting and fill in your NPI and Tax ID.
Electronic Data Request Form
Section A: Request Type
- Please Choose Add Electronic Remittance Advice.
Section B: Sender Information
- New applicants may leave the Sender Number blank.
- Please fill in your Business/Practice or Provider name and address.
- Please fill in the name of the contact person for your office and their phone & fax numbers as well as their e-mail address.
Section C: Vendor Information
- Please fill in the Software Vendor information provided above.
- For Contact position write in: Support
Section D: Delimiters
- For Element enter: *
- For Sub-element enter: :
- For Segment enter: ~
Section E: Signature/Medicare Provider Number
- If you are a Group Practice or Organization fill in your Practice/Org name and Medicare B Pin #
- If you are a Solo Provider fill in your Provider name and Medicare B Pin#
- Fill in your NPI and Tax ID or SSN
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. When the form is complete, print, sign, and date it, and either fax or mail to Medicare EDI.
P.O. Box 44071 - 3C
Jacksonville, FL 32231-4071
It is very important that you complete and fax the entire enrollment packet as described above. Incomplete packets will not be processed, and will be returned to the submitter.
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be mailed to you as notification to begin filing claims electronically. If a returned letter is not received after two weeks, contact the Technology Support Center at 1-888-670-0940, Option 4.
Once you have received your Submitter ID and password for First Coast, please call the SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission.
Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment, but will be validated against production files, therefore, they must contain valid patient procedure, diagnosis, and provider information.
From our customers
I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.
SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.
I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.
SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.
Easy to use, Customer support has always been excellent, Thanks SolAce Team.
I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.
Awesome customer service every time!
I can't tell you how wonderful it is to work with your agency. They are courteous, knowledgeable,friendly, and a joy to work with - I can't say enough. Thank you!!
The service was very good. Phone answered promptly even though it was around 6 p.m. my time. Very courteous and helpful. So far I have had really good experiences with your support team.
The follow-up is outstanding - whenever there is an issue I am contacted to be sure that all is working well and to my satisfaction.
Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.
Tech was very helpful, very patient and very professional. She knew of the issue quickly and stayed at hand until issue was resolved. Very satisifed with the service.