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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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