Submission of CEDI Enrollment Forms

CEDI has updated two validations within the CEDI enrollment form submission process to verify the DME supplier’s information while completing the forms. Previously these validations were done after submission. The validations will not allow submission of enrollment forms with invalid or incomplete information related to the Supplier’s Name and the DME Supplier Signature. Below is guidance on preventing and/or resolving these validations.

  • The authorized or delegated official’s name entered in the DME Supplier Signature field will be verified against PECOS and must match the authorized or delegated official’s name. Access PECOS at https://pecos.cms.hhs.gov/pecos/login.do to verify how the authorized or delegated official’s name is listed.

Important: The full name is required including punctuation. Please do not use initials or nicknames.

The CEDI enrollment forms will only accept the authorized and/or delegated official of the facility.  Clearinghouses, Billing Services and/or other Third Party Entities are NOT ALLOWED to sign enrollment forms and must not submit them on behalf of the supplier.

  • The Supplier Name on the enrollment form must match the Legal Business Name as it is in PECOS to be accepted. To verify the Supplier/Provider name please contact the NPEAST at 1-866-520-5193 or NPWEST at 1-866-238-9652 or access PECOS at https://pecos.cms.hhs.gov/pecos/login.do.

Important: Please include punctuation as it appears in PECOS. An exact match is required.

New forms are only required if modifications are needed to your current enrollment.

If you have any questions, please contact the CEDI Help Desk at ngs.cedihelpdesk@anthem.com or at 866-311-9184.

Post Date: 05/22/2023