Electronic Data Interchange (EDI)

The Health Care Financing Administration (HCFA) strongly encourages electronic claims submission. Suppliers who do not submit Medicare DMEPOS claims electronically should consider this option for a variety of reasons.

The electronic claims payment floor is just 14 days. A claim submitted on paper is subject to a 28-day payment floor.

EDI is available for all suppliers/providers. Participation/Assignment status is NOT a requirement to become an electronic submitter.

Other advantages include the following:

Increased cash flow
Filing claims more efficiently and accurately. Data is received precisely as input by the supplier's office, eliminating the chance of processing errors.
Front End Acknowledgment Report within 48 hours of transmission -Confirmation verifying the acceptance of claims and CMNs.
On-Line Claim Status Inquiry (CSI)
Availability of Electronic Remittance Notice (ERN) for faster payment postings.
Availability of Electronic Funds Transfer (EFT).
Eliminate paper, (no need to purchase HCFA-1500 forms). Ability to submit claims and CMNs 7 days a week, including holidays.
On-line beneficiary eligibility (participating, electronic suppliers only).

All 4 Regional Carriers (DMERCs) accept electronic claims. Contact your DMERC for details on how to sign up.

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