March 27, 2009
Issued on behalf of CEDI
Registering new PTAN/NSC numbers
Attention All CEDI Trading Partners, Suppliers, Billing Services, Clearinghouses, and Vendors
If you are a DME Supplier who has received a NEW PTAN/NSC Supplier number, you must notify CEDI Enrollment of the new PTAN/NSC number and its associated NPI. The new PTAN/NSC number must also be linked to the NPI in NPPES.
If you do not enroll the new PTAN/NSC number with CEDI and register it with NPPES, claims associated with this new PTAN/NSC number will be rejected.
- Claims submitted without a valid PTAN/NSC match on the NPI crosswalk, will be rejected with CEDI edit C003.
- Claims submitted before March 20, 2009 with an NPI linked to a PTAN/NSC not enrolled with CEDI will reject with DME MAC edit 20011.
After March 20, 2009, claims submitted with an NPI linked to a PTAN/NSC not enrolled with CEDI will be returned on the supplier's Electronic Remittance Advice or Standard Paper Remittance with the Reason/Remark Codes to indicate the "Claim service lacks information which is needed for adjudication" and/or "Electronic interchange agreement not on file for provider/submitter."
To resolve DME MAC edit 20011 or Remittance Reason/Remark Codes, suppliers must either:
- Complete the EDI Enrollment Form to register all PTAN/NSC numbers with CEDI. If you submit claims through a clearinghouse or third party biller, you will need to complete the Supplier Authorization Form as well as the EDI Enrollment Form. The EDI Enrollment and the Supplier Authorization Forms can be accessed through the CEDI Web site www.ngscedi.com under EDI Enrollment.
OR
- If you have an existing EDI Enrollment Form on file with CEDI for your NPI, you may submit an e-mail to cedienrollment@wellpoint.com with the Subject line reading: "Reason/Remark Code Supplier Not Authorized for EDI". Please include the following within your e-mail request:
- Submitter ID
- Submitter Name
- Address
- Contact Name
- NPI number
- The new PTAN/NSC that received the error.
CEDI will add your PTAN/NSC and notify you via e-mail when this has been completed. Once your CEDI enrollment has been completed, you can resubmit your claims.
