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Medicare Billing: CMS-1500 & 837P

Third-Party Transactions

If providers submit and receive transactions electronically using a third party like a billing agent or a clearinghouse, the A/B MACs or Common Electronic Data Interchange (CEDI) must notify these providers that they’re required to have an agreement signed by that third party. That third party must agree to meet the same Medicare security and privacy requirements that apply to those providers about viewing or using Medicare patient data.