A provider may submit a waiver request to their Medicare administrative contractor (MAC) claiming an “unusual circumstance” outside of their control prevents the submission of electronic claims. [CR 10559]
The Administrative Simplification Compliance Act (ASCA) is a law that requires all initial claims reimbursed under Medicare be submitted electronically, with limited exceptions.
Tips to avoid rejection of your Medicare EDI enrollment form. Avoid pitfalls when completing the EDI enrollment form. Submit your EDI enrollment form correct the first time and avoid processing delays.
This connectivity guide provides trading partners with instructions on how to successfully exchange electronic transactions with First Coast using the hypertext transfer protocol secure (HTTPS) Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules (CORE) compliant rules over the public internet.
This 276/277 Companion Guide provides trading partner instructions related to transactions based on ASC X12 Implementation Guides, version 005010. [CR 11131]
This 835I Companion Guide provides trading partner instructions related to transactions based on ASC X12 Implementation Guides, version 005010. [CR 11131]
The 837I Companion Guide provides trading partner instructions related to transactions based on ASC X12 Implementation Guides, version 005010. Version 6.2 of the 837I Companion Guide has been updated to provide guidance that Loop 2400 DTP03 Service Date – 35 must not be a future date. [CR 11131]
This 837P Companion Guide provides trading partner instructions related to transactions based on ASC X12 Implementation Guides, version 005010. [CR 11131]
Link to the Department of Health and Human Services' (DHHS) office for HIPAA privacy rule, which protects the privacy of individually identifiable health information.
The HETS is intended to allow the release of eligibility data to Medicare providers, suppliers, or their authorized billing agents for the purpose of preparing an accurate Medicare claim, determining beneficiary liability or determining eligibility for specific services.
Electronic Data Interchange (EDI) webpage on CMS.gov containing information on EDI transaction and corresponding paper claims requirements.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
