Interested Provider Questionnaire | Medicaid Reform | Participating Hospitals | Provider Manual | Credentialing Application Request Form (Must Be Accompanied with Provider Questionnaire)
First Coast Advantage is a Provider Service Network (PSN), established and operated by Shands Jacksonville, that coordinates benefits for Medicaid members under the State's Medicaid Reform plan.
The First Coast Advantage network includes Shands Jacksonville, University of Florida physicians, Nemours Children's Clinic, Wolfson Children's Hospital, Duval County Health Department, Community Providers, Baptist Medical Centers, Brooks Rehabilitation Hospital and Renaissance Behavioral Health Systems.
If you are interested in participating with First Coast Advantage, please complete the Interested Provider Questionnaire and Credentialing Application Request Form on-line, they are an interactive form. All interested providers must verify their Medicaid Information within the last 6-months with Medicaid, prior to submission of questionnaire and Credentialing Application Request Form. If information not verified with Medicaid, your questionnaire is subject to rejection.
Once Interested Provider Questionnaire and Credentialing Application Request Form is complete and Medicaid Information has been verified, fax the forms and any documents that you would like us to review to (904) 244-9409. For questions contact FCA at (904) 244-9016. Someone will respond to your request within 45 days.
Thank you for your interest in participating with First Coast Advantage (FCA) Medicaid Provider Service Network (PSN).