- Entry Process Questions
- General Information
- Choose Transaction Status
- Submitting the Packet
- EDI Enrollment Agreement Form
- EDI ERA Enrollment Form
- EDI Registration Form
- Part A Logon Request Form: Provider/Facility Requesting Access
- Provider Letter of Authorization
- Part A Logon Request Form: Billing Service Using a Letter of Authorization PIN
- Tracking my Enrollment Packet and Checking Status
- EDI Gateway Self-Service Password Portal
EDI Registration Form
This form is used for batch billing enrollment:
- Part A/B providers who submit batch transactions to Medicare, such as transmitting 837 claims, receiving 835 electronic remittances and requesting 276/277 claims status and response. Providers have the ability to submit directly to NGS as a direct-biller, or utilize a third party billing service or clearinghouse to submit on their behalf.
- Third Party Billing Services or Clearinghouses to obtain/update their Trading Partner ID.
Note: Up to 25 PTAN/NPI combinations within the same Contractor Code can be submitted through this form.
Section I: Action
This section is used to determine the necessary action taken for the PTAN(s) entered.
- Obtain TPID – Obtain a new Trading Partner ID for an entity. Note: TP IDs are contractor code-specific.
- Update TPID – Update an active Trading Partner ID currently on file with NGS (add PTAN(s), transaction types, software vendors, etc.).
- Note: Making updates to a TP ID can only be authorized by the owner of the ID.
- Link to Third Party – Providers allowing a billing service and/or clearinghouse to exchange transactions with NGS on their behalf.
- Submitter type – this field will auto-populate based on what is selected within the guided enrollment.
- What is the Trading Partner ID?
The ID used to exchange transactions with NGS. This is the 4-9 alpha-numeric ID (only required when the action Update TPID or Link to Third Party is selected in Section I).
Select Transactions Authorized for this Submitter
- Claims (837)
- Remittances (835)
- Claims Status and Response (276/266)
Note: these three transactions are auto-populated based on what is selected within the guided enrollment.
- Update Trading Partner Demographic Information – used to update the address and/or contact information currently on file with NGS (this is only available when the action Update TPID is selected in Section I). Note: Making updates to a TP ID can only be authorized by the owner of the ID.
Section II: Provider/Facility Information
- What is a Network Service Vendor?
The approved NSV that provides access to the NGS EDI gateway that you have a service agreement with (only required when the action Obtain or Update TPID is selected in Section I).