Part A/Part B/HHH EDI Enrollment (Agreement) Form and InstructionsEdi Enrollment Agreement • June 9th, 2020
Contract Type FiledJune 9th, 2020The EDI Enrollment Form (commonly referred to as the EDI Agreement) should be submitted when enrolling for electronic billing. It should be reviewed and signed only by the providers to ensure each provider is knowledgeable of the enrollment request and the associated requirements.