Common Contracts

1 similar Edi Enrollment Agreement contracts

Part A/Part B/HHH EDI Enrollment (Agreement) Form Instructions
Edi Enrollment Agreement • November 14th, 2022

The 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.

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