EDI Enrollment

Acronyms Intro Text

Acronyms, initialisms, and alphabetisms are abbreviations that are formed using the initial components in a phrase or name. These components may be individual letters (as in CMS) or parts of words. The following acronyms are used frequently on [...]

Acronym Search

ADR Calculator Bottom

Claims status information can be obtained using our claims/eligibility tools: Connex or the interactive voice response (IVR) system. Please learn more about these tools by visiting the Resources section of our Web site.

ADR Calculator Top

Additional Development/Documentation Request Timeline CalculatorUse this calculator to determine the target date that the requested medical records must be received by National Government Services. The ADR letter you received will indicate [...]

ADR Response Timeline

Appeals Calculator Header

Appeals CalculatorTo determine the timely filing date for your appeals request:Step OnePlease select an option from the drop-down based upon which level of appeal you are in (see table at bottom of page).Step TwoEnter the date on which you [...]

Appeals Calculator

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CERT Denial FinderThis tool allows you to quickly identify the outcome of a CERT review. If you disagree with the CERT denial you may exercise your appeal rights by beginning with the first level of the appeal process, which is a [...]

CERT Denial Reason Finder

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Claim Timely Filing CalculatorTo determine the timely filing limit for your service, please enter the date of service in MM/DD/YY or MM/DD/YYYY format and select Calculate. Select the Reset button to clear all data and submit a new query.

Claim Timely Filing Calculator

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EDI Front End Rejection Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for HHH

EDI Front End Rejection Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for FQHC

EDI Front End Rejection Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

EDI Front End Rejection Code Lookup Tool

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Medicare Participating Physicians DirectoryThe Medicare Participating Physicians Directory (MEDPARD) contains names, addresses, phone numbers, and specialties of all participating providers within the Medicare Part B Program who have agreed to [...]

CMS 1500 Claim Form

Fee Schedule Lookup

Medicare Beneficiary Identifier (MBI)

Medicare Secondary Payer (MSP)

NGSConnex

Top Claim Errors

About Appeals

Levels of Appeals and Time Limits for Filing

Reopenings for Minor Errors and Omissions

CMS Contact

Centers for Medicare & Medicaid ServicesTo offer comments to CMS on the performance of the MAC servicing your state/region, contact CMS at:Jurisdiction 6: OPOLE_IFM_CHIKCGP@cms.hhs.govJurisdiction K: OPOLE_IFM_NY@cms.hhs.gov

Administrative Simplification Compliance Act Waiver Request Form

Advance Beneficiary Notice of Noncoverage (CMS-R-131)

Appointment of Representative Form (CMS-1696)

Clerical Error/Omission Reopening Request Form

CMS -1561 Health Insurance Benefit Agreement

CMS Hospital Cost Report Forms and Instructions

CMS-20134 Medicare Enrollment Application - Medicare Diabetes Prevention Program Suppliers

CMS-588 Electronic Funds Transfer (EFT) Authorization Agreement

CMS-855A Medicare Enrollment Application - Institutional Providers

CMS-855B Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers

CMS-855I Medicare Enrollment Application - Physicians and Non-Physician Practitioners

CMS-855O Medicare Enrollment Application - For Eligible Ordering and Referring Physicians and Non-Physician Practitioners

EDI Help Desk information