Electronic Billing & EDI Transactions
This section contains information on:
- Our Electronic Data Interchange (EDI) transaction and corresponding paper claims requirements;
- Links to those Chapters of the Medicare Claims Processing Manual (pub.100-04) that contain further information on these types of transactions;
- Our Health Insurance Portability and Accountability Act (HIPAA) contingency plans;
- The Administrative Simplification Compliance Act (ASCA) requirement that claims be sent to Medicare electronically as a condition for payment;
- How you can obtain access to Medicare systems to submit or receive claim or beneficiary eligibility data electronically; and
- EDI support furnished by Medicare contractors.
Please see pages on specific types of EDI conducted by Medicare for related links and downloads as applicable.