Electronic Data Interchange (EDI)
If you need additional information, you may contact the WPS EDI Hotline at (877) 567-7261.
- Does Medicare require Taxonomy codes?
- If I switch clearinghouses, do I need to resubmit a new Electronic Data Interchange (EDI) enrollment form?
- What do I need to do to get set up for Electronic Remit Advice (ERA)?
- How long does not it take for the EDI and ERA forms to be processed?
- How do I get a duplicate remit?
- If my claim did not crossover to the patient's secondary insurance, should I call EDI?
1. Does Medicare require Taxonomy codes?
Medicare does not require Taxonomy codes, but they can be helpful in determining matches for a National Provider Identifier (NPI). If you send a Taxonomy code, you must follow the rules that apply to Taxonomy. If your electronic claim has a Taxonomy code, and your claim is crossed over to the next payer, that Taxonomy code will be sent. If the Taxonomy code is not present on the electronic claim, no Taxonomy code will be sent to the next payer. Taxonomy codes are not crossed over on paper claims submitted to Medicare.
2. 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 form 
.
3. 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 form .
4. How long does not 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.
5. How do I get a duplicate remit?
Providers receiving paper remits will need to contact the Medicare Customer Service Department.
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.
6. 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.
Page Last Updated: Thursday, 18-Mar-2010 05:55:52 CDT
