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September 18, 2018

Take Action Now: Part B DDE / PPTN User ID Annual Recertification

Each year, Medicare providers are required to recertify their Direct Data Entry (DDE) / Professional Provider Telecommunication Network (PPTN) User access. The recertification deadline for Part B PPTN Users is September 30, 2018.

Failure to recertify by the deadline dates will result in the termination of PPTN services.

Complete the Annual DDE PPTN Recertification FormPDF as soon as possible. Ensure that all users are listed. If there are more than 10 users please submit additional forms. You must submit your recertification form prior to the deadline (listed below) for your line of business.

Note: This form is not used to add new users, delete users, or to update current users. To add, delete, or update User ID information, you must complete an Online Inquiry ServicesPDF form.

FAX the completed form (for faster service) to:

Ohio Kentucky
Part B: 1.615.664.5927 Part B: 1.615.664.5917

Annual DDE PPTN Recertification Form Instructions

Step 1: Access the Annual DDE PPTN Recertification FormPDF
Step 2: Enter the user's ID, First Name, Middle Initial, and Last Name.
Step 3: Place an "X" in the Active field for current users or Place an "X" in the Inactive field for Users that no longer need or have access. Note: users that are no longer working for the facility should be marked as Inactive.
Step 4: Enter the name of the Authorized contact in the Authorized Signature field.
Step 5: Enter the email address of the Authorized contact.
Step 6: Enter the phone number of the Authorized contact.
Step 7: Print and Fax to the appropriate fax number on the bottom of the form.

Note: By completing and submitting this DDE/PPTN Recertification form you certify that you are authorized to complete this Annual Recertification on the behalf of the user.

If you have any questions concerning the recertification process, please contact the CGS J15 EDI department at 1.866.276.9558 (option 2).

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