Federal (United States) · Agency guidance
Chapter 24
121 sections
121 sections
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 10Introduction to Electronic Data Interchange (EDI) for Medicare
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 10.1Requirement for EDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 10.2Audience for this Chapter
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 10.3Scope of this Chapter
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 10.4Acronyms and Definitions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 20General EDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 20.1Legislative Background
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 20.2The America Reinvestment and Recovery Act (ARRA)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 20.3HIPAA and ARRA on Security and Privacy
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 20.4Administrative Simplification and Compliance Act (ASCA)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 30EDI Enrollment and Registration (AKA Trading Partner
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 30.1EDI Enrollment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 30.2New Enrollments and Maintenance of Existing Enrollments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 30.3Submitter Number
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 30.4Electronic Remittance Advice (ERA) Enrollment Form
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40Medicare FFS EDI Users Roles and Responsibilities in an EDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.1Centers for Medicare and Medicaid Services - Medicare Fee-For-
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.1.1HIPAA Transaction Standards as Designated by CMS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.1.2Transactions Used in the Acknowledgment of Receipt of
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.1.3Change Request (CR) to Communicate Policy
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2Medicare FFS Contractors (A/B MAC, DME MAC, CEDI)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.1Certification Test Program and Annual Recertification
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2.1A/B MACs, DME MACs, and CEDI Data Security and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2.2A/B MAC, DME MACs and CEDI Audit Trails
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2.3Requirements for A/B MACs, and CEDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2.4Release of Medicare Data
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.2.5EDI Enrollment and EDI Claim Record Retention
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.3General EDI Outreach Activities
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.3.1A/B MAC and DME MAC Analysis of Internal Information
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.3.2Contact With New Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.3.3Production and Distribution of Information to Increase Use of
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.3.4Production and Distribution of Material to Market EDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4Trading Partner Management
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.1User Guidelines
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.2Technical Assistance to EDI Trading Partners
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.3Training Content and Frequency
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.4Prohibition Against Requiring Use of Proprietary Software or
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.5Free Claim Submission Software
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.6Newsletters/Bulletin Board/Internet Publication of EDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.7Provider Guidelines for Choosing a Vendor
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.7.1Determining Goals/Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.7.2Vendor Selection
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.7.3Evaluating Proposals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.4.7.4Negotiating With Vendors
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.5Provision of EDI User Guidelines
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.6Provision and Maintenance of a Directory of Billing Software
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.2.7Operating Rules for Electronic Transactions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 40.3Trading Partners
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50Technical Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.1Telecommunications, Internet and Dial-up
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.1.1System Availability
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.1.2Media
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.1.3Telecommunications and Transmission Protocols
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.1.4Toll-Free Service
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.2Translators
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3Combined Common Edits/Enhancements Module (CCEM) -
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.1Claim Numbering
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.2Receipt Control and Balancing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.3Acknowledgements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.3.1Outbound File Compliance Check
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.4Combined Common Edits/Enhancement Module (CCEM) Code
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.5Handling of Poorly Formed/Invalid Flat Files for a 277CA
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.4CEDI - Unique Specifications for DME
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.4.1CEDI Claim Numbering
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.4.2CEDI Receipt Control and Balancing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.4.3CEDI Acknowledgments for ASC X12 Version 5010 and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.5EDI Testing Accuracy
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.5.1Limitation on Testing of Multiple Providers that Use the Same
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.5.2EDI Receiver Testing by A/B MACs, and CEDI
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.6Changes in Provider’s System or Vendor’s Software and Use of
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.7Delimiters
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.8Nulls
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.9Direct Data Entry (DDE) Screens
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.10Additional Documentation Submitted Via Paperwork (PWK)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.10.1PWK Background
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.10.2PWK Workflow
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.10.2.1Provider Responsibility
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.10.2.2Contractor Responsibility
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60EDI Edit Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.1A/B MACs, and CEDI Edit Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.2Key Shop and Optical Character Recognition
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.2.1Claim Key Shop and Optical Character Recognition
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.2.2Key Shop and Image Processing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.3COB Trading Partner and Contractor Crossover Claim
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.4Remittance Advice and Standard Paper Remittances
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.5Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.5.1Payment Floor Requirement
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.5.2Alternative to EFT
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.5.3Electronic Funds Transfer (EFT)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.5.4Tri-Partite Bank Agreement
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 60.6Health Care Provider Taxonomy Code (HPTC) Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 70CMS Defined File Formats
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 70.1General HIPAA EDI Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 70.2National Council for Prescription Drug Program (NCPDP) Claim
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 80Electronic Data Interchange (EDI) Reporting Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 80.1Contractor Monthly Status Reporting
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 80.2Combined Common Edits/Enhancement Module (CCEM)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 80.3Common Electronic Data Interchange (CEDI) Reporting
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 80.4HIPAA Transition Reporting