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March 17, 2016

Completing the EDI Application: Tips for Providers and Trading Partners

The EDI Application is used to establish or update submitter information electronically. We are noticing an increase in the number of applications being returned due to incomplete and/or inaccurate information submitted on the forms. To facilitate an accurate and timely enrollment, please be sure to avoid the following common errors:

  • We have seen an increase in Illegible forms. This typically occurs due to the forms being refaxed or bleeding of the inked letters from copies made repeatedly. ALL information on the form must be legible. This includes CGS print, script, phone numbers, provider information, Trading Partner information, disclaimer and agreement information. *If any of this information is illegible, your entire form and attachments will be returned.
  • Using an updated formPDF each time will ensure you have the most recent and legible copy.
  • Please make sure all EDI applications are signed and clearly indicated with 837/835 requests. (New set-ups will also require an EDI Enrollment form.) EDI forms may be found by accessing the CGS Web site. Select the Line of Business for your segment and choose the EDI link on the left. In the section of bulleted topics within the middle of the page, select EDI Enrollment PacketPDF.
  • Choose only ONE Line of Business per application.
  • The PTAN, name and address of the provider must match what is listed in our system before set up can be completed.
  • Multiple PTANs will require ONE application per Group PTAN.
  • Enrollment forms are needed only if your provider has never been set up to file electronic claims.
  • Any forms requiring a signature should be signed by a fully-authorized official from the office. The signature binds you to the agreement and and requested changes.

Please refer to our EDI webpage for additional resources available to you including articles, job aids, EDI manuals and user guides.

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