Important Reminders for Your EDI Enrollment
When completing the EDI Enrollment application, it’s important that the entity name and address you enter on the EDI enrollment form matches exactly to the information contained in the CMS-855/PECOS enrollment application.
If the name and address do not match, the EDI Enrollment will be denied.
What is the Entity Name?
- This is the exact provider’s name that was submitted in Section 2 of the CMS-855/PECOS enrollment application when applying to participate with Medicare.
What Information Should Be Put in the Fields for Street Address, City, State, ZIP, Telephone Number and Telephone Number Extension?
- The address must be an exact match of the physical practice address on file in Section 4 of the CMS-855/PECOS enrollment application. This may include suite/apartment, direction, or street/road designation. This is not an inclusive list. If there has been a change to the location of the provider, it must be submitted and approved on the CMS-855/PECOS application prior to submitting it on any EDI Requests.
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Posted 5/2/2024