Please allow 10 business days before contacting Electronic Data Interchange (EDI) Services for a status of electronic billing forms sent for processing.
Effective March 2, 2018, EDI Services will return all enrollment forms received that contain a form revision date older than R11-17.
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Novitasphere is a FREE, secure internet portal for Part A and B customers to use to easily connect directly to Novitas Solutions. Novitasphere provides quick access to beneficiary eligibility, claim submission, claim corrections (Part B), electronic remittance advice, and many other time saving features. To learn more and enroll for Novitasphere, visit the Novitasphere Center.
To connect to Novitas Solutions via Secure File Transfer Protocol (SFTP) directly or by billing service or clearinghouse, please review the EDI Enrollment forms below.
Prior to enrolling for electronic billing, please carefully review the Technical Requirements for electronic billing and the General Tips for Completing EDI Enrollment Forms.
This form should be completed by Part A providers requesting access to the Fiscal Intermediary Shared System (FISS).
EDI Third Party Enrollment Form (8291)
This form should only be completed by a vendor, billing service, or clearinghouse.
Providers who use an in-house software and will be requesting multiple submitter IDs, please complete this form to have your software added to our database.
Reason for Return
How to Avoid A Return
Invalid signature/printed name. The Authorized Official or Delegated Official as listed on the CMS-855 is required to sign.
This continues to be the number one reason forms are returned for corrections.
The Authorized Official or Delegated Official as listed on the CMS-855 is required to sign. If you are unsure who your authorized or delegated official(s) on file are, this information can be verified in the Provider Enrollment Chain and Ownership System (PECOS).
Missing/Incorrect name of provider, group or supplier
Ensure the provider name on the EDI forms matches the provider name that Novitas Solutions has on file. This is the name used when completing the CMS-855 form and enrolling with the Medicare program.
Your PTAN is assigned to you by Provider Enrollment upon completion of the CMS-855 form. Ensure the PTAN is reported in the required field. The PTAN is the same as your Provider Identification Number (PIN) that you used for billing prior to being required to report a National Provider Identifier (NPI). You may also know this as your legacy identifier or Medicare provider number.
Rendering PTAN/NPI given
EDI Enrollment is based on the group PTAN. Once the group PTAN is set up, the associated rendering PTANs are considered enrolled. It is not necessary to enroll group members.
The Maintain Existing Submitter/Receiver ID Setup block was incomplete
Review the Maintain Existing Submitter/Receiver ID Setup block and indicate if there are any submitter/receiver IDs you wish to maintain. This is a required block for existing EDI customers, and will be noted as incomplete if the form is being returned for other corrections.
Click here for information on the HTTPS CAQH CORE-Compliant Connection for EDI.
If you need assistance, please contact an EDI Analyst.