EDI Onboarding and Connectivity
The Customer Service Front End System (CSFES) receives and processes Medicare Part C, and Medicare Part D data as well as data from plans participating in the Medicare Medicaid Financial Alignment Initiative. To ensure proper exchange of this data, organizations must establish a secure connection with the Centers for Medicare and Medicaid Services (CMS) systems.
Organizations must contact a CMS approved Network Service Vendor (NSV) to establish connectivity with Palmetto GBA’s secure, encrypted network. Click here for the list of approved NSVs.
Organizations with less than 100,000 enrolled beneficiaries are able to establish connectivity directly with CMS. For assistance in establishing this connectivity, contact the Medicare Advantage Prescription Drug (MAPD) Help Desk at 1-800-927-8069 or by email at MAPDHELP@cms.hhs.gov.
Once connectivity has been established there are onboarding forms that must be completed.
- Electronic Data Interchange (EDI) Agreement
- Submitter/Receiver ID Application
- Submitter Authorization Form (for plans utilizing a Third Party Submitter)
- Connect:Direct Form(s)
A description of each form can be found by clicking the applicable link from the list provided below: