Importance of Reviewing Front-End Electronic Claim Reports

Have you ever experienced delays in claims processing, called the Provider Contact Center or checked claim status on the Noridian Medicare Portal (NMP), only to discover that Noridian does not have the claim? Despite transmitting the claim electronically, it seems to have gone missing.

To address this situation and ensure smoother processing, the Common Electronic Data Interchange (CEDI) contractor, National Government Services (NGS), offers a unified electronic front-end solution for all Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) suppliers. CEDI collaborates closely with DME MAC software vendors, billing services, clearinghouses, and electronic submitters (trading partners) to fulfill electronic front-end requirements.

CEDI handles several essential electronic transactions, including:

  • Electronic claims using American National Standards Institute (ANSI) X12N 837 and National Council for Prescription Drug Programs (NCPDP) formats
  • Delivery of electronic Front-End Acknowledgements and Reports
  • Electronic Remittance Advices (ERAs)
  • 276/277 Claim Status Request/Response

To ensure smooth processing and timely reception of claims within the DME claims processing system, suppliers must diligently review and address the Front-End Acknowledgements and Reports. Failure to act on these reports means Noridian will not receive the claim until it is corrected and resolved. Until CEDI accepts and processes the claim, transmitting it to Noridian, the claim will not be visible in the DME claim system.

By promptly reviewing Front-End Acknowledgement Reports and resolving any issues, suppliers can help expedite the electronic billing process, minimizing delays, and ensure efficient claim handling.

 

Last Updated Aug 28 , 2023