A number of electronic billing vendors have contacted CMS stating
that Medicare contractors are requiring EDI re-enrollment for
Health Insurance Portability and Accountability Act (HIPAA)
transaction use. Although this has not been a requirement of
BCBS of Arizona Medicare Part A, CMS has asked that we publish
clarification of existing EDI enrollment requirements.
A signed Centers for Medicare & Medicaid Services (CMS)
Medicare EDI Enrollment is required whenever claims are to
be sent to Medicare electronically. If a CMS Medicare EDI Enrollment
is on file, a new CMS Medicare EDI Enrollment is not required
to bill HIPAA claims. You are not required to periodically
re-sign for continued use of EDI. Changes such as going from
one format (National Standard Format) to another (X12) and/or
changing from one service/clearinghouse do not require a new
CMS Medicare EDI enrollment form.
If you would like to sign up to send claims electronically,
you can download the Centers for Medicare & Medicaid Services
(CMS) Medicare Enrollment form.
