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Posting Date: 06/20/2025
I Am Not Yet Enrolled in Medicare
You can only begin set up with EDI if you are a participating provider in the Medicare program. If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines. If you have a [...]
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Posting Date: 06/20/2025
Trading Partner ID Recertification
All active trading partners are required to recertify their access annually. CMS requires any changes in demographic, contact information or access for a trading partner ID (TP ID) are communicated to the A/B MAC within 30 days of the change. [...]
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Posting Date: 07/19/2023
National Government Services Contractor Codes
National Government Services Contractor Codes The Contractor Code is a five-digit numeric code that indicates your MAC, also known as the Carrier Code, or Payer ID. Part B Professional: Connecticut 13102 Illinois 06102 Maine 14112 [...]
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Posting Date: 05/03/2024
About Prior Authorization
About Prior Authorization CMS has implemented Prior Authorization (PA) programs nationwide to ensure that Medicare beneficiaries continue to receive reasonable and necessary care while protecting the Medicare Trust Fund from improper payments. [...]
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Posting Date: 06/09/2021
About Hospital OPD PA Model
About Hospital OPD PA Model Table of Contents General Information Related Content [Return to Top] General Information Question Description WHO It is the responsibility of the hospital OPD to submit all [...]
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Posting Date: 06/09/2021
OPD Facility/Physician Communication
OPD Facility/Physician Communication The implementation of the Outpatient Department (OPD) Prior Authorization (PA) program has specific implications for Part B physicians performing services within hospital OPDs. Each prior authorization [...]
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Posting Date: 06/09/2021
Ways to Submit Requests
Ways to Submit Requests NGSConnex Part A: NGSConnex User Guide Part B: NGSConnex User Guide esMD Content type 8.5 Fax JK: 317-841-4530 J6: 317-841-4528 Mail National Government Services, Inc. [...]
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Posting Date: 06/09/2021
Expedited Requests
Expedited Requests The requester may submit an expedited review of the PAR if it is determined that a delay could seriously jeopardize the beneficiary’s life, health, or ability to regain maximum function. If the medical documentation does not [...]
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