eServices Claim Submission (eClaim) Tips
- For newly registered providers, the Claim Submission tab will be available approximately 48 to 72 hours after registration. If users are not able to view the tab 72 hours after registration, they will need to contact the Provider Contact Center at
- JJ Part B: 877-567-7271
- JM Part B: 855-696-0705
- Railroad Medicare: 888-355-9165
- Street addresses must be submitted on the form. PO Boxes are not allowed, and will cause the claim to be rejected by the CMS Common Edit Module (CEM)
- Zip codes must include the extra four-digit suffix. A suffix with -0000 is not allowed. If the extra four-digit suffix is not known, the provider can use www.USPS.com and click on "Look up a Zip Code"
- Entities such as Ambulance providers, who do not qualify as a group practice, will need to select "Solo Practice" and then key in their "Organization Name." Only solo practice physicians should be filling out the "Provider Last Name" and "Provider First Name" fields when the "Solo Practice" option is selected.
- Group practices are required to input the rendering physician (at the service line level). This is not a requirement for solo practices.
- Up to five (5) attachments may be submitted and each attachment can be no larger than 5 MB. The attachments must be in PDF format.
- Each claim is submitted to the CMS Common Edit Module (CEM) as an initial claim. If a claim is rejected, the provider can correct the claim and resubmit it. However, if an attachment was included with the original claim submission, the provider will need to add the claim attachment again upon submitting the corrected claim.
- Please note that when the user accesses the "Rejected Claims" tab, only claims that were submitted via eServices will appear in the tab for editing
- When the user edits the rejected claim, the rejection messages from the 277CA will appear at the top of the form. However, once the user selects the "Submit" button, any form error message will overwrite the rejection messages at the top. The user may view their inbox message for the error list if it is still needed.
- If a claim is accepted by the CMS Common Edit Module (CEM), an Internal Control Number (ICN) will be assigned. If an attachment was submitted with an accepted claim, a Document Control Number (DCN) will be assigned as well. Both numbers will display on the accepted inbox message.
- The "Total Charges" field at the bottom of the Part B Claim form is an auto-calculated field. In order to have the field auto-calculate from the service line charges, users will need to ensure they are clicking the "Add Line Information" button after they key in each service line.
- For Medicare Secondary Payer (MSP) claims, the user will need to key in the information that the primary payer provided on their remittance. If there are any Line adjustments that need to be added (i.e., Claim Adjustment Group or Reason Codes), the user must key in those fields, then click "Add Line Adjustments" to add them to the service line.
- The user may then key in what is being billled to Medicare in the "Secondary Line Items" fields, then click "Add Line Information" so the entire service line (with Primary and Secondary information) is added to the claim form
- To edit rejected MSP claim lines with adjustments, the user will need to first select "Edit" in the line information table. This will auto-populate the fields that the user previously keyed for both Primary and Secondary Line Items. To edit the Line Adjustments, the user will need to click "Edit" in the Line Adjustments table next to each Group Code they wish to correct. The user will need to do this individually for each Group Code combination.