There may soon be an increased cost to submit claims to Medicare. Suppliers, clearinghouses, third party billers and software vendors are currently able to connect and transmit information directly to Medicare via several free modem and FTP network connections. However, during a vendor call on Sept. 8, CEDI (Common Electronic Data Interchange) announced that all direct connections to its gateway will be shut down over the next several months, and all electronic Medicare transactions will need to be transmitted through one of six select network service vendors: ECC Technologies, IVANS, McKesson CareBridge, MedXpress, VisionShare, or Nebo Systems Inc .
Effective Nov. 1, all new vendors and suppliers who aren’t actively submitting claims to CEDI will need to go through one of the above network service vendors, or through a clearinghouse that provides this service. All free connections to CEDI will be shut down for everyone else effective April 30, 2011.
The premise behind the service change is driven by CMS’ security concerns. National Government Services currently operates the CEDI contract, which is the entity responsible for the front-end editing of all claims traffic and transactions with the DME MAC contractors. NGS is closing all free modem and FTP connections to the CEDI gateway in order to meet requirements put forth in the Medicare Claims Processing Manual, Chapter 24 and the Internet Only Manual, Pub 100-17. The six network vendors mentioned above will be the only vendors allowed to transmit data between suppliers and CEDI via secure AT&T Global Network Service (AGNS) lines.
If you connect directly to the CEDI gateway to upload your claims, retrieve response reports, download Medicare ERNs or send claim status inquiries, you will likely be affected by the upcoming change in service. However, if you are already transmitting claims and other transactions to Medicare through a clearinghouse or one of the network service vendors above, you may not be affected by the transition. Suppliers who are currently using free network connections can expect to pay a per claim fee to a clearinghouse, or pay monthly fees for bandwidth time once the transition takes place.
It will still be possible to secure a direct line to CEDI by becoming a direct network service vendor, but this option will be cost prohibitive for most. IVANS and McKesson also serve as CMS’ authorized AT&T resellers.
Today, CEDI released a list serve announcement confirming the coming transition. A copy of the announcement and future updates will be made available at: http://www.ngscedi.com/news/newsindex.htm. Contact information for CEDI’s select network vendors is available at: http://www.ngscedi.com/telecomm/networkvendors.htm.
