I am new to Medicare DME and my claims are not processing as I am getting several error messages including my CEDI does not match my taxpayer ID, NPI or PTAN. What do I do?
The CEDI is a CMS operation which accepts electronic claims for all the DME MAC and electronically filters them to the correct DME MAC. As part of the enrollment into CEDI, one must provide them with several important pieces of information. Your tax identifier, NPI and PTAN. If any of those are incorrectly imbedded into your software, or if during the CEDI enrollment (this is not the same as NPE enrollment) this information was processed incorrectly all your DME claims will reject.
My advice is to consider taking the following trouble shooting steps:
Contact your software company to ensure that the data you submitted to the CEDI is the same as what you submitted to NPE.
Check the enrollment or revalidation letter from the NPE to ensure that the PTAN they sent you matches the CEDI information.
Check your tax identification information on the NPE enrollment, CEDI and in your software to ensure that they are the same across the board.
Be sure you are using the correct NPI to bill DME. Frequently many providers enrolled with a type I NPI for their local Medicare contractor and provided a Type II Organizational NPI to bill DME. Yet once their computer billing software was set up, the Type I NPI is being used to bill the DME MAC.
These are very intricate issues and may require some professional assistance from your software vendor. Until these are resolved and the Tax ID, NPI, PTAN and CEDI registration number all align, none of your claims will be paid.
