Get 8292p Form 2022-2024

If your communication is very sensitive, or includes personal information, you may want to contact the EDI Department by phone: JL Customers: 1-877-235-8073, option 3. JH Customers: 1-855-252-8782, option 3.

The Centers for Medicare & Medicaid Services (CMS) standard Electronic Data Interchange (EDI) enrollment form must be completed prior to submitting Electronic Media Claims (EMCs) or other EDI transactions to Medicare.

Type the contact person's name that has knowledge and authority to answer questions regarding your enrollment. Type the contact person's telephone number (including area code). Type the fax number (including area code) for the provider. Type the practice mailing address, including suite/building numbers/levels.

Shield of Florida Inc., acquired Highmark Medicare Services, Inc., from its parent company, Highmark, Inc. As a result, Highmark Medicare Services, Inc., changed its name to Novitas Solutions, Inc.

When claims are adjusted due to an overpayment, a Solicited Demand letter will be issued to you. If the claim adjustment is initiated due to a Recovery Audit review, the number in the upper right hand corner of the Solicited Demand letter will begin with an "R".

ENROLLMENT PACKET. This enrollment packet consists of an EDI Provider Application/Agreement Form, an Option Selection Form, an ERA Enrollment Form, Title 22 and Forms Reorder Request.

A submitter ID is an EDI-specific ID that drives access to SPOT. A submitter ID is required, even if you are not submitting claims or retrieving electronic claim files through SPOT.