US · guidance
CMS Pub. 100-04, ch. 24, § 40.2.3.2
Contact With New Providers
A/B MACs must conduct an analysis of the capability of each provider (including
physicians and suppliers) that contact a Medicare contractor to begin submission of
Medicare claims, or for DME MACs, when notified by the National Supplier
Clearinghouse that new supplier identification numbers have been issued. A/B MACs
shall use provider education to ensure that all providers/submitters are aware that EDI
transactions are to be presented as the normal mode of business for Medicare claims,
claim status, and remittance. A/B MACs shall also use provider education to ensure that
all providers/submitters are aware that EFT is the normal mode for funds transfer. See
Chapter 31 for HETS information on eligibility verification ASC X12 270/271 eligibility
transaction queries. Where the provider does not have the related capability, A/B MACs,
DME MACs and CEDI are to inform the providers of available options to begin use of
EDI, e.g., list of vendors and clearinghouses and billing services, availability of
Medicare’s free software.
History
(Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5bbdd2465024f1479d1816fe2808aa0a076a3f1bd9bc13222a390ccff1390e20
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