Florida Medicaid
Required Documents for those applying for new Submitter ID's
The following documents are required enrollment documents that must be completed, signed and returned to the FL Medicaid office prior to initiation of electronic claims submission or inquiry.
1. Electronic Data Interchange Agreement
If the link above does not work properly, please download the form directly from the website:
- http://portal.flmmis.com/FLPublic/Provider_EDI/Provider_EDI_RegistrationForms/tabId/64/Default.aspx
- Scroll to the bottom and click on the EDI Agreement link
If you have any questions regarding any of the documents in this package, please call the EDI Technology Support Center at 1-866-586-0961.
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 |
Electronic Data Interchange Agreement
Header
- Enter your Medicaid Provider ID and NPI
- Enter your Business/Practice or Provider Name
- Complete your demographic and contact information
- If you are a provider using SolAce to bill your claims directly to Medicaid, choose Provider
- If you are a Billing Service, choose Billing Agent/Clearinghouse
- Note to Billing Services: Once you receive your ID from Medicaid, you must have each of the providers you are billing for also complete a copy of this form and state they are a "Provider"
Section 1
- Providers using SolAce to bill directly can enter their current Trading Partner ID if they have one or leave this section blank
- Providers using a billing service must choose the second option and enter the billing services assigned Trading Partner ID on the line.
- For transactions sets please choose either 837I or 837P and 835
- 837I = Institutional claims, 837P = Professional claims, 835 = EOB's
Section 2
- Billing Services must complete this section. Provider's billing directly using SolAce may skip this section.
Section 3
- Please have the authorized official sign and date this section
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
For Regular Mail:
Gainwell Technologies Provider Enrollment
PO Box 7070
Tallahassee, FL 32314-7070
For Overnight or Express Delivery:
Gainwell Technologies Provider Enrollment
2671 Executive Center Circle West
Suite 100
Tallahassee, FL 32301
Email: flediteam@dxc.com
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 faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Technology Support Center toll-free at 1-866-586-0961.
Testing
Once you have received your Submitter ID and Password from FL Medicaid, please call the SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission.
Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.
customer Testimonial
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.
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.
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.
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.
Easy to use, Customer support has always been excellent, Thanks SolAce Team.
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.
Awesome customer service every time!
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!!
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.
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.
Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.
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.
