All health care providers who would like to submit the CMS-1500 using the XML submission process must first complete the online Medical Portal registration. After logging into the Medical Portal, providers who have not already signed up for XML submission of the CMS-1500, will see a link for "Agreement for XML submission of CMS-1500," under the Billing section. Select the link and click the "I Accept" button. The provider's name will be added to the Listing of Providers Authorized to Submit XML Data (MS Excel), which is updated daily. Once accepted, the link will no longer appear when you sign in again.
XML Submission Partner
Businesses who would like to register to become an XML submission partner must first register with the Board and will be required to successfully pass XML testing prior to their approval to submit XML data to the Board. Once the registration is received and eligibility to participate verified, the XML submission partner will be required to sign and return the testing legal agreement. The Board will notify the XML submission partner by email, at the email address provided on the registration, that the registration has been approved and testing can begin. Once the XML submission partner has successfully passed testing, the Board will notify the XML submission partner by email that they have been approved for production submissions and require the XML submission partner to sign and return a production legal agreement.
The electronic process, prescribed by the Chair, requires payers to partner with at least one Board-approved XML submission partner to transmit and accept health care provider medical bills via Electronic Data Exchange (EDI), or another format agreed upon with the XML submission partner.
Payers must designate with the Board, the XML submission partner(s) from whom they will accept medical bills by October 30, 2021. The payers' Medical Portal Online Administrators must keep XML submission partner information accurate and update the online administrator application with any changes within three (3) business days.
A list of approved XML submission partners for the CMS-1500 is posted on the XML Forms Submission section of the Board's website and is updated after each entity successfully completes testing and executes an XML Submission Partner Agreement with the Board.