How to sign up for electronic data interchange (EDI) services
Please help us set up your electronic transactions as quickly as possile by doing the following:
Only use the most current forms available on the EDI website
The EDI Resources page contains links to the forms to use. DMAP will not accept older versions of these forms:
- Trading Partner Agreement (DMAP 2080, version 10/11)
- Exhibit A – Application for Authorization (DMAP 2081, version 10/11)
- Exhibit B – EDI Registration (DMAP 2082, version 8/12)
- EDI Registration Change Form (DMAP 2083, version 8/12)
If a clearinghouse sends you older versions of these forms to complete, we will not accept them for processing.
For new providers, providers changing clearinghouses or changes to Authorized Signer, complete a current EDI Registration Packet (DMAP 2080PKT, revised 8/12)
The EDI Registration Packet includes the Trading Partner Agreement, Ehibit A and Exhibit B forms. All three forms are required in order to register for EDI services.
We also recommend that you use our EDI registration guide to make sure you have correctly completed all forms prior to mailing.
Sign all EDI forms in blue or black ink, and mail them to EDI Support Services.
- DMAP will not accept faxed, emailed or photocopied forms.
- DMAP will only accept mailed forms with original signatures in blue or black ink.
|
