EDI

KMAP secure website

Providers can submit electronic claims through this website without an EDI application or authorization test.

The following methods of claim submission require an EDI application and authorization test:

Provider Electronic Solutions

Provider Electronic Solutions (PES) is available at no cost to providers for all claim types. PES is a proprietary Windows-based software that enables providers to submit claims electronically, receive claim status, and verify beneficiary eligibility in a batch mode. Features such as reference lists, archiving, and searches save time by providing access to commonly used data. To download the PES software, click the link under the EDI tab of the KMAP secure website.

Third-party software

Providers and clearinghouses can use their own software to submit claims to KMAP.

Electronic claims clearinghouse

Providers can use a clearinghouse to submit claims to KMAP. They must be authorized by the fiscal agent.

Payment Advice Routing Instructions

This guide provides instruction for maintaining and routing payment advice information.

HIPAA Companion Guides

Certain companion guide documents have been approved for publishing to the KMAP provider community.

EDI INFORMATION

For answers to frequently asked questions, reference the EDI category on the FAQs page.

For additional EDI information, reference the Electronic Billing and EDI Transactions page of the CMS website.