To verify Medicare patients through Stedi, a one-time enrollment is required. This is what connects your practice to Medicare for eligibility checks.
How this works
There are two parts to setup. First, our team handles the initial provider setup in Stedi on your behalf (Step 1). To do that, we need the information listed below from you. Once we have it, we create your provider record and complete our portion, which typically takes 24 to 48 hours. After that is done, you complete your part, which is the attestation in Step 2.
In short: send us the information below, we complete Step 1, then you complete Step 2.
A note on the instructions: throughout the steps we link directly to Stedi's official directions and have mapped them into our own steps for ease, so you have both our walkthrough and the source instructions in one place.
Please note: Before any enrollment can be processed, your practice must already have an active agreement with your MAC (Medicare Administrative Contractor) to submit Medicare claims electronically. If you do not submit Medicare claims electronically today, complete claims enrollment first, then come back to finish the attestation in Step 2.
What we need from you to begin
The billing NPI your Medicare claims are submitted under. If claims are billed under your practice or group, use the group (organization) NPI. If claims are billed under an individual provider, use the individual NPI. This must match what is on file with CMS.
Your group EIN (Tax ID), or SSN if applicable.
The exact legal or display name of the group as registered with Medicare.
The provider's PTAN.
A contact email address for enrollment correspondence.
The MAC provider portal you use to submit claims. You will use this in Step 2.
What we will provide to you: one or more Trading Partner Unique IDs. These are specific to your enrollment, and you will enter them during the attestation in Step 2. We will send you the exact ID(s) when we confirm Step 1 is complete. Some providers have more than one, so you may need to complete the attestation more than once, once per ID.
Step 1: Provider setup (our team)
Once we have the information above, our team creates your provider record in Stedi and completes the initial setup on your behalf. This typically takes 24 to 48 hours. We will confirm with you when this is done, and that is your signal to begin Step 2.
Step 2: Complete the CMS Eligibility Attestation (MBI Lookup)
Link for instructions and reference: https://enrollments.stedi.com/CMS-MBI-Lookup-eb9685bc14df82918dd7017a9ec764b2
CMS requires an Eligibility Attestation for providers who use Stedi to check Medicare eligibility. If you do not complete attestation, your Medicare eligibility checks will stop working. To complete it:
Make sure you already submit Medicare claims electronically with a Medicare contractor (MAC). This is the prerequisite noted above. If you don't know what that is, view the section "How to find your MAC."
Complete the attestation with one MAC where you submit claims electronically. You do not need to do it for every MAC.
When asked for the clearinghouse or vendor unique ID (also called the Trading Partner Unique ID), enter the ID we provide you. We will send the exact ID(s) when we confirm Step 1 is complete. Use the same NPI you use for electronic claims submission with your MAC. If we send you more than one ID, complete the attestation once for each, marking each task complete in Stedi. The Stedi guide linked above lists each ID and the matching instructions for your MAC.
You are done when your MAC approves the request. MAC approval can take several business days, so plan accordingly.
How to find your MAC
If you already know your MAC, skip to the MAC guide link below.
If you do not know your MAC:
Look up your NPI in the CMS Medicare enrollment dataset: Medicare Fee-for-Service Public Provider Enrollment.
Check your Provider Type Description and enrollment state:
If you are enrolled as a DME supplier, complete attestation through CEDI.
If you are enrolled as Home Health or Hospice, use the HH&H rows in the table and match your state.
Everyone else uses the A&B rows and matches their state.
Follow the HETS EDI Enrollment (Attestation) instructions for the MAC listed.
Your MAC attestation guide: https://enrollments.stedi.com/CMS-MBI-Lookup-eb9685bc14df82918dd7017a9ec764b2
What happens next
Once your attestation is approved by your MAC, the enrollment moves to the payer for processing. We will confirm with you as soon as it is live, and we will then schedule a brief session to run a test eligibility check and verify everything end to end.
Helpful CMS links
Medicare Fee-for-Service Public Provider Enrollment dataset: https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/medicare-fee-for-service-public-provider-enrollment/data
Questions
Reach out to your Omnivers contact at any time. If anything in your MAC portal looks different from what is described here, send us a screenshot and we will walk through it together on a call.