EDI Provider Recertification

National Government Services will start conducting an annual security recertification of all current online system users for Medicare Part A FISS Direct Data Entry (DDE) providers located in Ohio, Indiana, Kentucky, Virginia and Michigan and Medicare Part B Professional Provider Telecommunications Network (PPTN) providers located in Indiana and Kentucky. The deadline for this recertification is Thursday, July 31, 2008. This will require action from FISS/DDE and PPTN users.

National Government Services is requiring office managers to complete an online "Provider Recertification Form". This "Provider Recertification Form" will require managers to provide facility and contact information, including a listing of all active online user IDs with the name of each person using each ID. Failure to complete this form by the Thursday, July 31, 2008 deadline will result in a disruption to your FISS/DDE and/or PPTN access. This recertification will not change current user IDs or access.

* Required Fields

System *
Facility Name *
Facility State *
Contact Name *
Contact Phone *
Email Address *

Primary Provider Number *

FISS/DDE User ID or PPTN User ID*	Users First Name*	Users Last Name*

I certify that the User IDs and User names listed above are accurate and currently in use for the FISS/DDE or PPTN Medicare Online systems.*