District of Columbia Medicaid: ACS

Please follow the Enrollment Instructions below to become an electronic submitter for Disctrict of Columbia Medicaid ACS.

Required Documents

The following documents are required enrollment documents that must be completed, signed and returned to the Medicaid office prior to initiation of electronic claims submission or inquiry.

  1. EDI Provider Enrollment Form
  2. EDI Trading Partner Agreement

To obtain the forms above, please download them from:

https://www.dc-medicaid.com/dcwebportal/providerSpecificInformation/providerInformation

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

Our Vendor Information

Vendor Name - AXIOM Systems, Inc.
Contact - EDI Team
Vendor Code - N/A
Phone - 602-439-2525
Fax - 602-439-0808
Address - 241 East 4th Street, Suite 200
Frederick, MD 21701
Software Name - SolAce EMC
E-mail - Support@SolAce-emc.com

EDI Provider Enrollment Form

Section 1

  • Please select the appropriate classification for your business, either Individual or Group

Section 2

  • If submitting claims yourself using SolAce please select Vendor Software
  • If you plan to have a billing agency submit claims on your behalf please select Billing Agent Clearinghouse and then complete form 11 titled EDI Authorization for Billing Agents, Clearinghouses, and Software Vendors

Section 3

  • Fill in your demographic and contact information
  • Please ensure you enter the correct Provider Number (Solo NPI) or Group Number (Group NPI)

Section 4

  • Leave this section blank since you are applying for a new submitter ID

Section 5

  • Please enter the demographic and contact information for two contacts in your office

Section 6

  • Select Software Vendor if using SolAce
  • Select Billing Agent if you will be using a billing agency
  • If you are using SolAce then enter in Axiom System’s demographic and contact information located in the box above
  • If you are using a Billing Agency enter that company’s demographic and contact information
  •  

Section 6b

  • If you are using SolAce to submit your claims please enter: SolAce EMC Version 4.0 Protocol ZModem

Section 6c

  • If you are using a Billing Agency you will need to get their ID
  • If you are using SolAce please leave this blank

Section 7a

  • Please Skip

Section 7b

  • If you going to be sending professional claims select X12N 837P
  • If you are going to be sending institutional claims select X12 837I

Section 8

  • Leave blank for default

Section 9

  • Select the following options:
  • X12 277CA
  • X12N999
  • X12N 835

Section 10

  • Please add any additional providers on this last page

 

Trading Partner Agreement

  • Please complete the Submitter Section on the last page.
  • New Applicants can enter Provider Name as Submitter and leave Trading Partner ID blank.
  • Please Sign, enter Title, and Date this application.

 

Authorization Form for Billing Agents and Clearinghouses

Only fill out this form if using a billing service

Section A

  • Please indicate your appropriate classification, either Individual Provider or Group Practice
  • Fill in your Contact and Demographic information
  • Please ensure you enter the correct Provider Number (Solo NPI) or Group Number (Group NPI)

Section B

  • Please type your name (the name of the provider) and then enter the name and submitter ID of the billing service you wish to authorize to submit claims on your behalf.
  • If you would like the EOB’s and Reports to be sent to the Billing Service, please select: 277CA, 999, and 835
  • The Provider must print their name, sign and date

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records.  Please MAIL the forms listed above to:

 

     Xerox State Healthcare, LLC

     Technical Support/Enrollment

     PO Box 34734

     Washington DC 20043-4761

    Fax to: 202-906-8399

 

It is very important that you complete and return the entire enrollment packet as described above.  Incomplete packets will not be processed and will be returned to the submitter.

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed.  Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither notification, nor a returned enrollment packet is received after 2 weeks, please call 866-752-9231 option 2 then option 3 for EDI; then option 1 for DC Medicaid

 

Testing

Once you have received your Submitter ID and Password from Medicaid, please call the SolAce Support Team and set an appointment for a Mailbox setup. Testing is optional for this payer.   

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customer Testimonial

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customers From our customers

I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.

Shani Madaminova,
Administrator
Best Home Care, Inc
Jersey City, NJ

SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.

Susie Doran Carter, Westcare Management, Inc.
LTC Medicare Consultant and Billing Service
Salem, OR

I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.

Carolyn Boles
From the office of Donald J. Boles Jr. MD PC
Tempe, AZ

SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.

S. Bowling
Idabel, Oklahoma

Easy to use, Customer support has always been excellent, Thanks SolAce Team.

Carl Shepherd
IT Administrator
THE WYNN GROUP, INC
Dublin, GA

I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.

Denise
Margate, FL

Awesome customer service every time!

Denise
Bellevue, NE

I can't tell you how wonderful it is to work with your agency. They are courteous, knowledgeable,friendly, and a joy to work with - I can't say enough. Thank you!!

Doreen
Bemidj, MN

The service was very good. Phone answered promptly even though it was around 6 p.m. my time. Very courteous and helpful. So far I have had really good experiences with your support team.

George
Mahornet, IL

The follow-up is outstanding - whenever there is an issue I am contacted to be sure that all is working well and to my satisfaction.

Joan
Batavia, IL

Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.

Patricia
Orlando, FL

Tech was very helpful, very patient and very professional. She knew of the issue quickly and stayed at hand until issue was resolved. Very satisifed with the service.

Sherry
Largo, FL