Coding and claim mechanics are national. What changes at a state line is everything around them: who adjudicates your Medicare claims and hears your appeals, what your Medicaid program is called and whether a commercial plan sits in front of it, whether an auto injury is the health plan's problem or the auto carrier's — and how a billing company is permitted to charge you.
In Florida, Medicare is administered by First Coast Service Options (JN). Medicaid runs as Statewide Medicaid Managed Care (SMMC), delivered largely through commercial managed care plans — so most Medicaid claims are adjudicated by an insurer with its own filing window and authorization rules rather than by the state.
Florida is a no-fault state. For an auto injury the auto carrier pays first, not the health plan, and billing the health plan first produces a denial that looks like a coverage problem but is really a sequencing problem.
White Glove Medical Billing is a medical billing, coding, and revenue cycle company — not a healthcare provider and not a law firm. All coding is performed by certified coders from your providers' documentation; the clinical record and the certification of medical necessity remain the provider's.
At a glance
Medicare contractor
First Coast Service Options (JN)
Medicaid program
Statewide Medicaid Managed Care (SMMC)
Medicaid delivery
Commercial managed care plans
Auto injuries
No-fault — auto carrier pays first
Appeals in Florida
First Coast Service Options (JN) is who hears the first level of appeal for a Medicare denial here. That matters practically: an appeal argument that works with one contractor generally works across every state it covers, and local coverage determinations mean the same service can be covered in Florida and not one state over.
What we handle for Florida practices
- Medical coding by certified coders, from your documentation
- Charge entry, claim scrubbing, and electronic submission
- Clearinghouse rejection follow-up and denial management
- Payment posting reconciled to your bank deposits
- Aged A/R worked by recoverability, not by date
- No-fault and auto-injury claims sequenced to the Florida auto carrier first
- Patient statements, payment plans, and a billing support line
A note on Florida business taxes
Not a service we sell, and not advice — but a practice is still a business with a state footprint, and it comes up often enough to be worth stating. Florida administers sales tax through the Florida Department of Revenue. Most clinical services are not taxable, but retail sales — supplements, cosmetics, optical, DME sold rather than billed — frequently are. Employer registration runs through the Florida Department of Commerce, and the entity itself is registered with the Florida Division of Corporations. Your CPA owns all of it; we mention it because the retail side of a practice is where it usually surfaces.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your Florida aging, denial mix, and payer panel.
Scope and price
A written scope, and the Florida rate card above confirmed in writing.
Transition
Coding and submission move across without a gap.
Report
Six numbers monthly, segmented by payer and provider.
Medical billing pricing in Florida
Split — flat on government plans, percentage on commercial
flat + 6–8% depending on payer
Government-plan work is billed as a flat monthly fee and commercial payer work as a percentage of collections, so the arrangement is clean on both sides of your payer mix.
Why Florida is different. Florida restricts percentage-based arrangements on Medicaid dollars. Our pricing here is set accordingly — this describes what we charge, not what you are permitted to do, and it is not legal advice.
Solo
$2,000/mo
$0–$50,000 a month collected
1 provider
tracks 8%
Growing
$7,500/mo
$50,000–$150,000 a month collected
2–4 providers
tracks 7.5%
Established
$19,250/mo
$150,000–$400,000 a month collected
5–9 providers
tracks 7%
Group
$45,500/mo
$400,000–$1,000,000 a month collected
10–20 providers
tracks 6.5%
Large Group
from $60,000/mo
$1,000,000+ a month collected
20+ providers or multi-site
tracks 6%
Every ongoing engagement carries a minimum monthly fee of $500. It exists so a new or small practice can be served properly rather than quoted a percentage that does not cover the work.
What changes the work in Florida
- Medicare contractor
- First Coast Service Options (JN)
- Claims for Florida providers are adjudicated here, and this is who hears the first level of appeal.
- Medicaid program
- Statewide Medicaid Managed Care (SMMC)
- Delivered largely through commercial managed care plans, so most Florida Medicaid claims go to a health plan rather than to the state.
- Auto injuries
- No-fault / PIP state
- In Florida the auto carrier is the payer of first resort for an auto injury, not the health plan. Billing the health plan first is a denial waiting to happen.
Front-end services in Florida
These are priced per occurrence and are the same in every state. They can be bought on their own, without a billing contract.
| Eligibility check | $5 per patient |
| Full benefits verification | $10–$14 per patient |
| Prior authorization, standard | $12 per authorization |
| Prior authorization, complex | $18–$25 per authorization |
| Patient registration audit | $4 per patient |
What we report every month
- Days in A/R — How long money takes to arrive.
- A/R over 90 days — What share of what you are owed is going stale.
- Clean claim rate — How often a claim is paid without rework.
- Net collection rate — Of what was collectable, how much we collected. The number that grades the whole engagement.
- Denial rate by reason — Grouped by cause, so it points at a fix rather than a total.
- Charge lag — Days from date of service to claim submission — often your number to fix rather than ours, which is exactly why you can see it.
Florida Guides
Florida Sales Tax Filing
Tracked, reconciled, and filed on the cadence Florida assigns you.
Open guideFlorida Tax Agency Directory
Who administers what, with rates and thresholds as of August 2026.
Open guideAll Medical Billing Services
Monthly close, cleanup, AR/AP, payroll, job costing, and more.
Open guideFlorida Medical Billing by Specialty
These specialties have medical billing that genuinely differs in Florida — workers compensation schedules, no-fault auto rules, or Medicaid structure.
Florida — Frequently Asked Questions
Which Medicare contractor covers Florida?
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First Coast Service Options (JN). That is who adjudicates your Medicare claims, publishes the local coverage determinations that bind you, and hears a redetermination.
Is Florida Medicaid managed care?
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Statewide Medicaid Managed Care (SMMC) is delivered largely through commercial managed care plans. Nationally about 78% of Medicaid beneficiaries are in comprehensive managed care, and five companies account for roughly half of that enrollment — so "billing Medicaid" here usually means billing a commercial insurer.
How do you price in Florida?
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Florida restricts percentage-based arrangements on Medicaid dollars. Our pricing here is set accordingly — that describes what we charge, and your own position is a question for your counsel rather than for us.
Do we have to be in Florida to work with you?
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No — we work remotely with practices in all 50 states and DC. What matters is that somebody is tracking Florida's rules against your actual claims, which is what this page is for.
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