National Government Services Medicare (NGS Medicare) is a Medicare contractor. Since 1966, the company has provided services to the U.S. government agency CMS Medicare.
NGS Medicare administers Medicare Part A, covering hospitalization in Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin.
Electronic Data Interchange
EDI is an electronic communication method that enables the fast, accurate, and reliable exchange of data between the computer systems of organizations that do business together by using the same standardized message formatting, without the need for human intervention.
Our providers communicate with NGS using one of our approved NSVs through SFTP Gateway for all approved transactions or directly through our Internet Gateway for the 276/277 and 835 transactions.
To enroll access the EDI Enrollment section under Resources. Additional information on various EDI Solutions can be accessed on the left-hand menu.
Benefits Of EDI And Real-Time Claim Status
Taking advantage of online enrollment and submitting claims can have a number of benefits. Claims and other transactions submitted electronically usually process much faster than those submitted via paper.
Paper claims are held on the payment floor for 29 days while electronic claims are held on the payment floor for 14 days.
Some of the other advantages of electronic submission include:
- Increased cash flow and lower administrative costs
- Ease of billing
- Added efficiency and accurate claims filing
Real-Time Claim Status And Response
Receive your claim status response in minutes instead of hours. All you have to do is format your 276 claim status request to contain one transaction per ST-SE. Files containing multiple transactions per ST-SE will be routed through the normal process.
Please note that the real-time process will run during the existing claim system availability on regular business days. The process will not be available on weekends and holidays. Files eligible for the real-time process received during off-hours will be held and processed when the systems become available.