CAQH CORE 250: Claim Status Infrastructure Rule Guides CAQH CORE 250 Rule for operating rules for the eligibility and claim status transactions adopts all the Phase I and II CAQH CORE Eligibility and Claim Status Operating Rules except those requirements pertaining to the use of Acknowledgements. Entities seeking CORE Certification must implement all of the CAQH CORE Eligibility and Claim Read More →

EDI 837 Institutional Quiz

CGS EDI Enrollment Provider Guidelines CGS EDI Enrollment form (commonly referred to as the EDI Agreement) should be submitted when enrolling for electronic billing. It should be reviewed and signed only by the providers to ensure each provider is knowledgeable of the enrollment request and the associated requirements. Providers that have contracted with a third Read More →


CGS EDI Program: Advantages and myCGS Portal CGS EDI Program offers advantages to providers who conduct business with Medicare electronically. Some of those benefits include: No more paper claims: EDI (submitting claims to CGS electronically eliminates paperwork so your staff can accomplish more in less time. You will also save money on postage and claim forms. Earlier payment Read More →

EDI quiz

Top 10 ANSI Claim Rejections Examples Top 10 ANSI Claim Rejections occur at multiple locations within the electronic EDI claim. Suppliers are strongly encouraged to review all aspects of a claim denial. Find below Top 10 ANSI Claim Rejections. X222.087. 2010AA. NM109.050 This Claim is rejected for relational field due to Billing Provider’s submitter not approved for electronic claim Read More →