Electronic Data Interchange (EDI) FAQs

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If you need additional information, you may contact the WPS EDI Hotline at (866) 503-9670.

  1. Why am I getting a letter requesting proof that I meet the requirements to submit paper claims to Medicare, when I have previously been granted a waiver to bill paper claims?
  2. Why am I getting claims deleted for Claim Frequency Code? I am correcting previously denied claims and want to submit a correct claim.
  3. If I switch clearinghouses, do I need to resubmit a new Electronic Data Interchange (EDI) enrollment form?
  4. What do I need to do to get set up for Electronic Remit Advice (ERA)?
  5. How long does it take for the EDI and ERA forms to be processed?
  6. How do I get a duplicate remit?
  7. If my claim did not crossover to the patient's secondary insurance, should I call EDI?
  1. Why am I getting a letter requesting proof that I meet the requirements to submit paper claims to Medicare, when I have previously been granted a waiver to bill paper claims?

    Waivers to bill paper claims are good for two years. After two years, reverification is required by CMS. Please follow the instructions in the letter to submit the required documentation. EDI does not answer questions about a waiver. The hotline number is available only if you would like to receive the free software. You can fax the required documentation to (618) 998-5287.

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  3. Why am I getting claims deleted for Claim Frequency Code? I am correcting previously denied claims and want to submit a correct claim.

    Medicare Part B cannot accept any claim frequency code except "1" which means new claim. When a claim is denied or considered unprocessable, the claim is no longer available for correction. A claim, with the corrected information, must be submitted as a new claim. The claim frequency code for Medicare Part B claims must always be "1". (Loop 2300 CLM05-3)

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  5. If I switch clearinghouses, do I need to resubmit a new Electronic Data Interchange (EDI) enrollment form?

    No, it is not necessary to send in a new EDI enrollment form. If you are currently receiving Electronic Remittance Advice (ERA) notices, you will need to complete a new ERA form in order for your new clearinghouse to receive the remits. If remittance is not involved, you can complete the EDI Change of Submitter formAdobe Portable Document Format.

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  7. What do I need to do to get set up for Electronic Remit Advice (ERA)?

    You will need to complete and return the Electronic Remittance Advice (ERA) Authorization formAdobe Portable Document Format. If you are not already signed up to bill electronically, you will also need to complete and EDI Enrollment formAdobe Portable Document Format.

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  9. How long does it take for the EDI and ERA forms to be processed?

    It may take up to 14 business days for the EDI and ERA forms to be processed. A confirmation e-mail will be sent to the contact person provided on the form for ERA requests only

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  11. How do I get a duplicate remit?

    Providers receiving paper remits may request a copy through C-SNAP at http://www.medicareinfo.com(external link). You may also send a request in writing. To do this go to http://www.wpsmedicare.com and choose Contact Us. Find the proper address under General Correspondence for your state and submit a written request. Providers receiving ERAs may call the appropriate EDI Department to have the file resent. If you use a clearinghouse to receive your ERA and did not receive it from them, you will need to contact the clearinghouse for assistance.

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  13. If my claim did not crossover to the patient's secondary insurance, should I call EDI?

    No. EDI does not handle crossover issues. The secondary insurance should be registered with the Coordination of Benefits Contractor (COBC). The secondary insurer must contact the COBC.

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Page Last Updated: Tuesday, 26-Jul-2011 15:48:32 CDT