z Novitas Solutions, Inc. (Novitas) is authorized to distribute PC-ACE/PRINTLINK/ETRA (herein referred to as the "Program") to authorized users.
PC-ACE and PRINTLINK software programs are copyrights of ABILITY. The Program is distributed for the purpose of creating electronic Medicare
claim files only. Any use not authorized herein is strictly prohibited, including but not limited to, making copies of any part of the Program,
reselling or transferring copies to any party, or creating any modified or derivative work.
z The Program is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of
merchantability or fitness for particular purpose.
z In no event will Novitas be liable for any loss or damage, including but not limited to incidental or consequential damages, arising out of the use or
inability to use the Program even if Novitas has been advised of the possibility of such damages, or for any claim by any other party.
z The authorized user will upgrade this Program within 90 days of upgrade availability. This is a CMS requirement.
z The authorized user will provide the necessary office space, all electrical and telephone connections, hardware, telecommunication software and
equipment that adhere to the technical requirements located at:
z Internet download is the preferred method of software installation. Internet download instructions will be provided upon processing of this enrollment.
There is no fee for software installation via Internet download. To receive the Program in CD-ROM format, visit
for ordering instructions. A non-refundable $100
annual service fee is required. This service fee covers four quarterly PC-ACE releases.
ADDITIONAL INFORMATION (Optional)
Preference for Aggregation of Remittance Data (e.g., Account Number Linkage to Provider Identifier)
Provider Tax Identification Number (TIN)
National Provider Identifier (NPI)
The provider agrees to the following provisions for submitting Medicare claims electronically to CMS or to CMS A/B MACs or CEDI:
The Provider Agrees:
1. That it will be responsible for all Medicare claims submitted to CMS or a designated CMS contractor by itself, its employees, or its agents.
2. That it will not disclose any information concerning a Medicare beneficiary to any other person or organization, except CMS and/or its A/B MACs,
DME MACs or CEDI without the express written permission of the Medicare beneficiary or his/her parent or legal guardian, or where required for the
care and treatment of a beneficiary who is unable to provide written consent, or to bill insurance primary or supplementary to Medicare, or as required
by State or Federal law.
3. That it will submit claims only on behalf of those Medicare beneficiaries who have given their written authorization to do so, and to certify that required
beneficiary signatures, or legally authorized signatures on behalf of beneficiaries, are on file.
4. That it will ensure that every electronic entry can be readily associated and identified with an original source document. Each source document must
reflect the following information: Beneficiary's name, beneficiary's health insurance claim number, date(s) of service, diagnosis/nature of illness, and
5. That the Secretary of Health and Human Services or his/her designee and/or the A/B MAC, DME MAC, CEDI or other contractor if designated by CMS
has the right to audit and confirm information submitted by the provider and shall have access to all original source documents and medical records
related to the provider's submissions, including the beneficiary's authorization and signature. All incorrect payments that are discovered as a result of
such an audit shall be adjusted according to the applicable provisions of the Social Security Act, Federal regulations, and CMS guidelines.
6. That it will ensure that all claims for Medicare primary payment have been developed for other insurance involvement and that Medicare is the primary
7. That it will submit claims that are accurate, complete, and truthful.
8. That it will retain all original source documentation and medical records pertaining to any such particular Medicare claim for a period of at least 6 years,
3 months after the bill is paid.
9. That it will affix the CMS-assigned unique identifier number (submitter identifier) of the provider on each claim electronically transmitted to the A/B
MAC, CEDI, or other contractor if designated by CMS.
10. That the CMS-assigned unique identifier number (submitter identifier) or NPI constitutes the provider's legal electronic signature and constitutes an
assurance by the provider that services were performed as billed.
11. That it will use sufficient security procedures (including compliance with all provisions of the HIPAA security regulations) to ensure that all
transmissions of documents are authorized and protect all beneficiary-specific data from improper access.
12. That it will acknowledge that all claims will be paid from Federal funds, that the submission of such claims is a claim for payment under the Medicare
program, and that anyone who misrepresents or falsifies or causes to be misrepresented or falsified any record or other information relating to that claim
that is required pursuant to this Agreement may, upon conviction, be subject to a fine and/or imprisonment under applicable Federal law.
13. That it will establish and maintain procedures and controls so that information concerning Medicare beneficiaries, or any information obtained from
CMS or its A/B MAC, DME MAC, CEDI, or other contractor if designated by CMS, shall not be used by agents, officers, or employees of the billing
service except as provided by the A/B MAC, DME MAC, or CEDI (in accordance with §1106(a) of the Social Security Act) (the Act).
14. That it will research and correct claim discrepancies.
15. That it will notify the A/B MAC, CEDI or other contractor if designated by CMS within 2 business days if any transmitted data are received in an
unintelligible or garbled form.
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When checking the box to enroll, you are agreeing to the software terms listed below
ENROLL FOR ABILITY | PC-ACE
ABILITY | PC-ACE ENROLLMENT (Optional)