Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 18, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: Is there an occasion where the EDGE server would provide an Accept or Reject status for every record received in the submitted inbound file?

Answer: Yes, if the EDGE Server Medical Claim Submission (ESMCS) claim header passes, and there are several claim lines, some of which are accepted and some of which are rejected, the issuer would get an Accept-Reject message. At the header level it would say rejected because more than one (1) claim line failed; therefore the header has to be rejected as well, but in that case there would be detail on each claim line. Likewise, for the Enrollment file, if the parent passes, detail on the child will always be provided.

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