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.
Note: Clearinghouse and other third-party representatives must get and use their own unique EDI access number and password from the A/B MACs or CEDI they’ll use to send or receive EDI transactions.
Resources
- Medicare Claims Processing Manual, Chapter 24
- Electronic Billing & EDI Transactions webpage