Medicare Enrollment

The term Medicare Enrollment can mean a couple of different things depending on the context in which it is being used. Patients must enroll in Medicare in order to receive health insurance benefits, and clinicians must enroll in order to be reimbursed for services they provide to Medicare patients. Outside of benefits eligibility verification, medical billers don’t normally deal with Medicare patient enrollment. Click here for more information on PracticeAdmin’s automatic eligibility verification module.

Medicare now requires most medical claims to be sent electronically in order to be paid, and providers must go through an enrollment process to submit their claims electronically. For this reason, medical billers and coders often use the term “enrollment” to describe the process of getting an electronic data interchange, or EDI connection setup so that the provider’s claims can be sent to payors electronically.

PA makes the EDI enrollment process a breeze for PA customers. After signing up with PracticeAdmin, a PA customer service representative will send you the necessary paperwork for enrolling all providers for EDI with Medicare, Medicaid, as well as commercial insurance plans. All you have to do is complete the paperwork and send it back, a PA customer service representative will do all the busy work, such as making phone calls to the payors to check on the status of your enrollment application, and will let you know as soon as your EDI connection has been turned on. PracticeAdmin web-based medical billing software contains a fully integrated, national, medical claims clearinghouse. This means that you don’t have to create batches to send out EDI, but rather can just create claims and save them for release. The PA software automatically creates batches and releases them EDI when there is the least amount of traffic on the system.

Additional information on Medicare EDI Enrollment can be found at:

Medicare Part A EDI Enrollment Helpline- http://www.cms.hhs.gov/ElectronicBillingEDITrans/Downloads/Medicare%20Part%20A%20EDI%20Helpline3.pdf

Medicare Part B EDI Enrollment Helpline- http://www.cms.hhs.gov/ElectronicBillingEDITrans/Downloads/Medicare%20Part%20B%20EDI%20Helpline3.pdf