Targeted Probe and Educate: Medical Review Topics

Targeted Probe and Educate: Medical Review Topics The Medical Review team has developed a comprehensive list of common denials found during Targeted Probe and Educate reviews along with resources to assist you in understanding how to avoid [...]

Activation of Validation Edits for Providers with Multiple Service Locations (MLN Matters Number: SE19007 Revised)

Activation of Validation Edits for Providers with Multiple Service Locations (MLN Matters Number: SE19007 Revised) Posted 7/20/2023

MLN Connects® Newsletter: July 20, 2023

MLN Connects® Newsletter: July 20, 2023 News Percutaneous Transluminal Angioplasty of Carotid Artery Concurrent with Stenting: Proposed National Coverage Determination Beta Amyloid Positron Emission Tomography in Dementia and [...]

Selecting the Submitter Type

Selecting the Submitter Type Each submitter type includes a description and the available tasks that can be completed for each. There are three submitter types:  Provider – The provider of service.  The Authorized or [...]

Completing the Registration Forms

Completing the Registration Forms  Complete all required fields marked with an asterisk or you will not be able to proceed with the submission of the form. The type of registration form and required information is going to vary depending [...]

EDI Gateway Self-Service Password Portal

EDI Gateway Self-Service Password Portal As an EDI Trading Partner, you will be able to use the EDI Gateway Self-Service Password Portal located on the EDI web page on our website. This provides a simple and secure web-based process for [...]

EDI Enrollment Process User Guide

Selecting Which System To Connect To

Selecting Which System To Connect To Select one objective based on the description provided and then click Next. Note: The options displayed will vary based on the submitter type selected.   

Submitting the Packet

Submitting the Packet After the enrollment packet is submitted, a confirmation message is displayed on the screen with the assigned Packet ID (PID) number. This has completed the submission process. You will be given the options to Print this [...]

Multi-Jurisdictional CAC Meeting Notice on Cervical Fusion

Multi-Jurisdictional CAC Meeting Notice on Cervical Fusion Information has been posted on our website in regards to multi-jurisdictional Contractor Advisory Committee Meeting regarding Cervical Fusion to be held on 8/16/2023. For more [...]