• Electronic Data Interchange (EDI)
Approved Network Service Vendors Submitter Authorization Form
• Front-End Systems User Guides
Front-End Systems User Guides
• Medicare Encounter Data
Companion Guides ED Testing Edits EDPS Bulletins Enroll to Submit Encounter Data HPMS Memos ListServ Newsletters PC ACE Pro32 Report and File Layouts Resources Training Information User Group
• Medicare Medicaid Plans
Companion Guides Edits Enroll to Submit Medicare-Medicaid Data FAQs HPMS Memos ListServ Medicare-Medicaid Testing References Report Layouts State Agency Information Training
• Prescription Drug Event
Coverage Gap Discount Program Drug Data Processing System (DDPS) Edits Enroll to Submit PDE File Layouts Frequently Asked Questions ListServ National Drug Code (NDC) Payment Reconciliation Summary Reports (PRS) Prescription Drug Front-End System (PDFS) References Report Layouts Social Security Number Removal Initiative (SSNRI) Updates Training User Group
• Risk Adjustment Processing System
Edits Enroll to Submit Risk Adjustment Data Front-End Risk Adjustment System (FERAS) HPMS Memos Job Aids ListServ Newsletters RAPS Bulletins References Risk Adjustment Processing System (RAPS) Training User Group

Welcome to the Customer Service and Support Center (CSSC) for Medicare-Medicaid Plans (MMP) Organizations submitting Medicare-Medicaid Data. The CSSC and the Front End System (FES) look forward to working with you in all aspects of the submission of Medicare-Medicaid Data.

The following information must be completed and sent to the CSSC for enrollment for the submission of Medicare-Medicaid Data:

• EDI Agreement for Medicare-Medicaid Data collection
• Online Submitter Application
• Medicare-Medicaid Connect:Direct Application Form

Please note the following for submitting Medicare-Medicaid Data:

• A CMS Medicare-Medicaid Data EDI Agreement must be completed by each submitter and on file with CSSC, prior to submitting Medicare-Medicaid Data. The agreement must be signed by an authorized agent of the organization and returned to CSSC Operations at the address provided.

• Use of Third Party Submitters: If the submitter will be an entity other than an MMP organization, the Submitter must complete the Submitter ID Application form; and the Submitter and MMP organization must complete the EDI Agreement. This EDI Agreement must be completed, signed and returned for each Plan number submitting data. Regardless who submits the data, CMS holds the MMP organization accountable for the content of the submission.

• A Submitter ID will be assigned to you by the CSSC and will remain effective for ongoing submission of Medicare-Medicaid Data. This is the unique ID assigned to the Plan or entity that will submit data and retrieve reports. Please complete the online Submitter Application and return the completed EDI Agreement to:

Palmetto GBA
CSSC Operations AG-570
2300 Springdale Drive Bldg. One
Camden, South Carolina, 29020-1728

• You will be submitting all Medicare-Medicaid Encounter Data to the FES.  Data will be submitted in the following formats:
  • ANSI 5010 format
  • Prescription Drug Event (PDE)
  • Risk Adjustment (RAPS) format
  • National Council for Prescription Drug Programs (NCPDP)

All data submitted to the front-end will be sent to one of the following:

• Encounter Data Processing System (EDPS) in the ANSI 5010 format
• Drug Data Processing System (DDPS) in the PDE format
• Risk Adjustment Processing System (RAPS) in the RAPS format
• State Agencies
  
  
• Datasets are required to be set up for Connect: Direct users. The Medicare-Medicaid Data Connect: Direct Specifications should be completed and returned to the CSSC with the Submitter Application and the EDI Agreement.

• Reports are returned on submitted data. Naming conventions for FTP submitters reports will be posted on the www.csscoperations.com web site.

We encourage you to visit the site and register for e-mail notification of all updates. Please contact the CSSC Help Line at 1-877-534-2772 with any questions regarding the information provided.