Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed, and returned to the ACS office prior to initiation of electronic claims submission or inquiry. 1. 837 Entity Information Request Form 2. 835 Access Request Form If you have any questions regarding any of the documents in this package, please call the CDPHP EDI Technology Support Center at 1-518-641-3000

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Process for those applying for new Submitter IDs

To Enroll in Alabama Medicaid's Electronic Data Interchange system please call the SolAce Support Team at 602-439-2525. We will contact Alabama Medicaid for you and sign you up for a Trading Partner ID, User ID and Password, so that you may send your claims Electronically via SolAce.

Testing

Once we have received your Submitter ID and Password from AL Medicaid, we will set an appointment with you for a Mailbox setup and Test Transmission to AL Medicaid.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter IDs

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. Trading Partner Agreement Enrollment Instructions for Providers http://www1.scdhhs.gov/openpublic/hipaa/webfiles/TPE%2010-2011%20Providers%20ONLY.pdf If you have any questions regarding any of the documents in this package, please phone the Medicaid EDI Technology Support Center at 1-888-289-0709 option 2.

Required Information

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents/Process

To become a direct submitter to the Tufts B2B Gateway system, please send an email to edi_operations@tufts-health.com. In the body of your message let them know you would like to begin submitting 837 files directly to the Tufts B2B Gateway system. Please include your Tufts ID, Tax ID and NPI as well as your Organization's name in your email.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter IDs

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. Trading Partner Agreement (not available in PDF, you must download the Word Format.) (Click on “Word Format” next to Trading Partner Agreement)

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Enrollment Procedures:

Applicants must first enroll for an EMOMED account at www.emomed.com Please follow the instructions below on how to apply for your Emomed account:
  • Open your Internet browser and go to www.emomed.com
  • On the right, in the Login box, click on Register Now
  • Press Continue
  • Click I Agree on the Agreement
  • Enter the characters as seen
  • Select your biller type
  • Complete the rest of the form with your information, see notes below

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

To Apply for a Submitter ID:

  • To apply, providers must call 573-751-7432 and press option 2 to speak to a tech.
  • Ask for Hope Berhorst and tell her that you are interested in Batching into CIMOR via FTP.
  • At that time she will give your Test site address and log in ID.

Required Information

We recommend that you have the following information ready before filling out your forms:

Wyoming Blue Cross Blue Shield claims will now be handled by the Availity Clearinghouse. 

Please click here to review our Availity enrollment instructions.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI). All providers must first register for Noridian’s Total Onboarding System in order to become an electronic submitter. Guides can be found at http://www.edissweb.com/cgp/forms/onboard.html Once you have established your Total On Boarding Account, please log into your account.
  • On the first page, click the “Manage NPIs” button and choose your billing NPI.
  • Select the transaction types you want to enroll your Billing NPI for:
    • For Professional claims, click “Enroll” for 837P (5010A1)
    • For Institutional claims, click “Enroll” for 837I (5010A1)
    • To receive your EOBs electronically, click “Enroll” for 835 (5010A1)

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI). All providers must first register for Noridian’s Total Onboarding System in order to become an electronic submitter. Guides can be found at http://www.edissweb.com/cgp/forms/onboard.html Once you have established your Total On Boarding Account, please log into your account.
  • On the first page, click the “Manage NPIs” button and choose your billing NPI.
  • Select the transaction types you want to enroll your Billing NPI for:
    • For Professional claims, click “Enroll” for 837P (5010A1)
    • For Institutional claims, click “Enroll” for 837I (5010A1)
    • To receive your EOBs electronically, click “Enroll” for 835 (5010A1)

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