Enrolling with CEDI is easy!

Completing Forms:

CEDI enrollment forms must be completed and submitted on-line. Once your information is entered into the form, click the “Submit” button at the bottom of the screen. This will generate a printable version of the form for you to print, sign, date, and fax to the number located on the printed form. Do not print the screen before you click on “Submit”.

We have provided a check list for new providers to help make the process easier.
CEDI Enrollment Check List for New Providers

Submitted CEDI enrollment forms will be issued Request Identification (RID) numbers which will appear on the printed copy of the form. The RID is used to track the submitted form. Forms that are printed before clicking the “Submit” button or have missing/invalid information will not be assigned an RID number. Verify your form(s) has an RID number before faxing.

IMPORTANT: Forms that are not printed after clicking on “Submit” and/or are not signed, dated, and faxed to CEDI will not be processed.

To help you avoid getting your forms returned, check out our guide on How to Avoid Common Errors When Completing Enrollment Forms

Checking Status of Submitted CEDI Forms:

CEDI has an Interactive Voice Response (IVR) System to check the status of submitted enrollment forms 24 hours after the on-line submission.

The CEDI Enrollment IVR Guide is provided to assist in using the IVR.

To check status of your form(s) call 1-866-311-9184 Option 2 and follow the prompts. The system will request the RID number from the form in order to check status.

CEDI Enrollment Application Status Tool
This inquiry tool gives you an update on your application instantly and can be used to check the status of the following common electronic data interchange (CEDI) enrollment forms.

Enrollment Forms and Instructional Guides:

Below are the enrollment forms used by CEDI. Review the “Complete for:” column to see if you need to complete the form. Then review the Instructional Guide if you need assistance in completing the required form.

Important Information!

Effective October 1, 2011 only 5010 transactions options can be setup for New Trading Partners. Any existing Trading Partners adding new transactions can only receive 5010 transaction options.

Effective November 15, 2011, CEDI will no longer accept requests for new suppliers to be setup for the 4010A1/5.1 transaction options.

All enrollment forms received beginning November 15, 2011 will be processed for the 5010A1/D.0 transaction options. Verify with your vendor that they are approved for the 5010A1/D.0 transaction options before completing any enrollment forms.

Form Number	Enrollment Forms and Instructional Guides	Complete for:
1	CMS EDI Enrollment Form Instructional Guide	Every New DME MAC Electronic Trading Partner (If you do not already have an existing Sender or Submitter ID, please complete the Submitter Action Request Form along with the EDI Enrollment form.)
		Trading Partners to add a new PTAN/NSC or NPI number to an existing Submitter ID
2	Supplier Submitter Action Request Form Instructional Guide	Every new DME MAC Electronic Trading Partner (Must also complete the CMS EDI Enrollment Form)
		Ordering the PC-ACE Pro32 Software Program (Check box included on the form, under Section II - SOFTWARE VENDOR)
		Existing Trading Partners to:
		• Changing software vendors
		• Changing Network Service Vendors (NSV)
		• Request the addition of a new transaction
3	CEDI Supplier Authorization Form Instructional Guide	Suppliers using a Clearinghouse, Billing Service or other Third Party to exchange any transactions with CEDI (This includes claims, ERAs and 276/277 transactions.)
		Existing Trading Partners changing to a Clearinghouse, Billing Service or Third Party Biller
4	Address and Contact Information Change Form	Trading Partners who wish to update the address or contact information associated with the Submitter ID
		This form will only update the address and contact information on file with CEDI
		Used by existing Trading Partners
5	CEDI Recertification Form Instructional Guide	Beginning in 2011, the National Government Services, Inc. Common Electronic Data Interchange (CEDI) will begin requiring all CEDI Trading Partners to re-certify their user access on an annual basis.

What to Expect:

When CEDI forms are submitted, an acknowledgment e-mail will be generated and sent back to the e-mail address on the form. (NOTE: The confirmation e-mail for the Supplier Authorization Form will be sent to the 3rd party biller or clearinghouse listed on the form.)

Once the request has been approved and processed, a setup confirmation will be sent via e-mail. For security purposes, confirmation of enrollment requests for a new Trading Partner (Submitter) ID requiring a password will be sent in two e-mails. The Trading Partner (Submitter) ID will be included in the first e-mail and the password will be sent in the second e-mail. If and e-mail is returned as undeliverable, CEDI will respond with the setup confirmation via fax or mail.

Passwords:

The initial password is a default password which will expire immediately and requires the user to establish a confidential, unique password. Passwords will expire every 60 days. Password requirements are listed below:

• Passwords must be eight (8) characters in length. No more and no less.
• Passwords must contain a combination of number and alpha characters.
• Password must contain a special character; for example @, #, $
• The CEDI gateway is case sensitive.
• Passwords are only good for 60 days, at which time the user will be required to reset the password.
• After three (3) incorrect login attempts, the account will be locked. Please contact the CEDI Help Desk at 866-311-9184 to have your password reset.
• The ID history retains the last 9 passwords the user has chosen. These cannot be reused.
• Passwords must not be stored in scripts, files, or applications unless compensating controls are in place.

Note: Trading Partner (Submitter) IDs will automatically be suspended after 90 days of inactivity and become inactive after 13 months of inactivity.

Note: CMS strictly prohibits any trading partner from outsourcing system functions overseas, unless explicitly authorized, in writing, by the CMS CIO. Any request for access by an overseas party must be immediately denied by National Government Services pending authorization from CMS.

CMS’ information security policy strictly prohibits the sharing or loaning of Medicare assigned IDs and passwords. Users should take appropriate measures to prevent unauthorized disclosure or modification of assigned IDs and passwords. Violation of this policy will result in revocation of all methods of system access, including but not limited to EDI front-end access or EDC RACF user access. The Medicare contractor shall notify all affected providers as well as reporting the system revocation to CMS.

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