The Centers for Medicare & Medicaid Services (CMS) Standard Electronic Data Interchange (EDI) Enrollment Form must be completed prior to submitting electronic media claims (EMC) or other EDI transactions to Medicare. The agreement must be executed by each provider of health care services, physician, or supplier that intends to submit EMC or use EDI, either directly with Medicare or through a billing service or clearinghouse.

Each new EMC biller must sign the form and submit it to their local Medicare carrier, durable medical equipment regional carrier (DMERC), or fiscal intermediary. For more information regarding the CMS Standard EDI Enrollment Form, please contact your local Carrier, DMERC or Intermediary.

An organization comprising of multiple components that have been assigned Medicare provider numbers, supplier numbers, or UPINs may elect to execute a single EDI Enrollment Form on behalf of the organizational components to which these numbers have been assigned. The organization as a whole is held responsible for the performance of its components.

See the Medicare Claims Processing Manual (Pub.100-04), Chapter 24, Sections 40 - 40.6 for further information.

Downloads
There are no Downloads
Related Links Inside CMS
Manuals
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 12/14/2005 12:00:00 AM
Help with File Formats and Plug-Ins