SolAce Electronic Medical Claims - Direct

Tricare East: Palmetto GBA

cneely — Thu, 02 Jan 2025 15:06:31 +0000

As of January 1 2025, Palmetto GBA is the new contractor for Tricare East claims.

Direct Submitters must complete a Trading Partner Agreement and Enrollment Form to be assigned a mailbox/Submitter ID.

Please contact the Palmetto GBA EDI Help Desk at 1-800-259-0264 or email them at EDI.TRICARE@PGBA.com to request they send you the appropriate forms for you to become a direct submitter. Once you have the forms, please call our helpdesk for assistance completing them at 602-439-2525, option 1 for Support.

Page Category:

Direct

Independence BCBS

cneely — Mon, 06 May 2024 18:46:30 +0000

Please follow the Enrollment Instructions below to become an electronic submitter for Independence BCBS.

Please Note: These instructions are specifically for EDI Submission to Independence under the following Payer IDs:

PAYER	ID
Independence BCBS	54704
Keystone Health Plan	95056
Independence Administrators	54763

Required Process for those applying for new Submitter IDs

The following online enrollment must be completed prior to initiation of electronic claims submission or inquiry.

SmartDataStream Account Registration

If the above link does not work properly, please follow these steps:

Go to the following site: Trading Partner Information Center for Independence Blue Cross (sdata.us) then click the "New account registration" link.

If you have any questions regarding this registration, please phone the Independence Support Team at the following number: 855-297-4436

Our Vendor Information

Vendor Name - AXIOM Systems, Inc.

Contact - EDI Team

Vendor Code - N/A

Phone - 602-439-2525

Fax - 602-439-0808

Address - 241 East 4th Street, Suite 200
Frederick, MD 21701

Software Name - SolAce EMC

E-mail - Support@SolAce-emc.com

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

Account Registration

Provider Details

Please enter your Provider Name
Please enter your Tax ID and NPI

Contact Information

Enter the primary Contact Name, Phone & Email address

Acceptance and Submission Section

Please check the "I'm not a robot" captcha box
Review your information and Submit

Trading Partner Agreement and/or Services Contract

After Registration is Completed, please log into Smart Data Stream and complete the Trading Partner Agreement

SFTP Registration

Upon creation of your SDS Account, you will need to complete the SFTP Registration Form to request an SFTP Login ID and Password. Please call our helpdesk at 602-439-2525 for assistance completing the form.

Waiting for a Response

Once the registration process outlined above has been completed, your SFTP Registration form will be processed. Processing will take approximately three to five business days from the date of receipt

After processing, a confirmation will be emailed to you with your Trading Partner ID, SFTP Login ID, and Password as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the BCBS EDI Technology Support Center at 855-297-4436

Mailbox Setup

Once you have received your Submitter ID and SFTP Login ID and Password from BCBS, please call the SolAce Support Team at 602-439-2525 and set an appointment for a Mailbox setup and first Production File Transmission to BCBS. Testing is not required for this Payer.

Page Category:

BC/BS

Direct

TriWest VACCN Regions 4 & 5 Palmetto GBA

cneely — Fri, 16 Apr 2021 22:17:47 +0000

Please follow the Enrollment Instructions below to become an electronic submitter to Palmetto GBA for your TriWest Region 4 & 5 claims. Please Note: this is only for claims that need to be sent to Payer ID TWVACCN. For TriCare West claim submission, which is Payer ID 99726, please review the instructions found on this page instead: https://solace-emc.axiom-systems..com/tricare-west-palmetto-gba

The following documents are required enrollment documents that must be completed, signed and returned to the PGBA office prior to initiation of electronic claims submission or inquiry. you must either call them at 1-800-259-0264 option 1, or email them to request they send you these forms: PGBA.EDI@PGBA.com

1. PGBA, LLC VACCN Electronic Trading Partner Agreement

2. PGBA, LLC VACCN EDIG Trading Partner Enrollment Form

(Billing Services please contact Palmetto directly for the forms and instructions on how to complete them.)

If you have any questions regarding any of the documents in this package, please phone the PGBA EDI Technology Support Center at 1-800-259-0264 option 1.

Our Vendor Information

Vendor Name - AXIOM Systems, Inc.

Contact - EDI Team

Vendor Code - N/A

Phone - 602-439-2525

Fax - 602-439-0808

Address - 241 East 4th Street, Suite 200
Frederick, MD 21701

Software Name - SolAce EMC

E-mail - Support@SolAce-emc.com

PGBA, LLC VACCN Electronic Trading Partner Agreement

Please leave the Agreement Number line blank
Enter today’s date and your Business/Practice or Provider name in the first paragraph (You are the Trading Partner)
Please complete section 9.1 on page 13 with your information (This tells PGBA who they should send notices to)
Complete the Trading Partner section on the left side of page 16
Complete Exhibit A
- Enter your information in the Trading Partner section
- Enter the software vendor information provided above in the Vendor information table. For AXIOM’s Tax ID please call us at 602-439-2525
- If you are a provider using a Billing Service, please enter the Billing Services information in the Billing Service Information section
  - Please also make sure you also contact Palmetto directly to inquire if any additional forms are required
On Exhibit A Page 2 Please Write in under Means of Electronic Access " Secure FTP" and "Will use AXIOM Systems Inc's IP and Certificate"

EDIG Trading Partner Enrollment Form

Enter today’s date
New applicants, please select “New Trading Partner ID”
Complete the Trading Partner Name field with your Business/Practice or Provider name
Leave the Trading Partner ID line blank if you are applying for a new ID and fill in your Tax ID in the Tax ID line
For Type of Business select either Institutional or Professional
- If you are a Billing Service, please choose Billing Service
- Please also make sure to contact them to see if any additional forms are required
For Line of Business, please choose “VA CCN”
Enter today’s date for the start date and leave the end date blank
Compression: choose PKZIP
Protocol: choose Secure FTP ( on the left in the blank area write in "will use AXIOM Systems Inc's IP and Certificate" )
Complete your address and contact information.
For Transactions, choose:
- ASC X12N 835 for Electronic Remits (EOB's)
- ASC X12N 837I for Institutional, or
- ASC X12N 837P for Professional
- For every transaction checked, provide an average number of transactions submitted weekly
For Vendor’s information enter: AXIOM Systems, Inc.
- Address: 241 East 4th Street, Suite 200 Frederick, MD 21701
- Transactions: 837P-5010 (for professional claims) and/or 837I-5010 (for institutional claims)
Complete the Customers Information section with your information
Leave the last page blank

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Email the forms to the following addresses:

PGBA.EDI@PGBA.com

It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two to three weeks from the date of receipt.

After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after three weeks, contact the PGBA, LLC EDI Technology Support Center at 1-800-259-0264.

Mailbox Set Up

Once you have received your Submitter ID and Password from PGBA, LLC, please call the SolAce Support Team at 602-439-2525 and set an appointment for a Mailbox setup.

Page Category:

Direct

West Virginia BCBS (Highmark)

cneely — Tue, 08 Jan 2019 21:16:44 +0000

Please click the following link for instructions on applying for a Submitter ID with Highmark: https://solace-emc.axiom-systems..com/highmark-west-virginia

Page Category:

BC/BS

Direct

J5 WPS: Nebraska Medicare

cneely — Fri, 23 Feb 2018 18:03:55 +0000

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 5, which includes Nebraska. If you are a provider located in Jurisdiction 5 and need to become an electronic submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

WPS recently implemented their new WPS EDI Express Enrollment Self-Service tool for Trading Partner enrollment and management. This will allow you to create your own account, register your line of business and transactions, and retrieve and submit agreements.

EDI Enrollment

Please click the following link to begin registration: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml

Click "Enroll", click the CAPTCHA then press "Continue"
Click "Enroll Now" under Providers if you are a healthcare provider

- If you are a Billing Service please give us a call at 602-439-2525 for assistance registering
Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)
Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)
On the next screen, please select "I Don't use a clearinghouse/billing agency"
Click "Register Now" to begin registration for a WPS Community Manager account
On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"
In the new tab that opens, please click "Start Registering"
Next, please enter your company name with no unnecessary symbols (exclude commas and periods)
Please enter your email address
Enter the Captcha displayed for security purposes then click "Next"
On the following screen please enter your company address, phone, fax and email
Do not enter anything for web URL
Please enter the primary legal and support contact information then press "Next" to continue
For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"
Review the Registration Summary for accuracy then click "Confirm and Submit"
You should receive an email confirming they have received your request and it is pending approval
- Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager
- Please click the link and set your password with the following requirements:
  - At least 15 characters long with at least one upper case, lower case, a number and a symbol
  - Please keep this information as it will need to be given to your ClaimShuttle representative after you finish registration
  - If you do not get the subsequent email, please call ClaimShuttle for assistance setting your Community Manager Password
You can now go back to EDI Express enrollment to finish registration
Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"
- If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"
If necessary, re-enter the email and press "Continue Enrollment"
Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info
On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement
Electronically sign the agreement by entering your name and pressing "Sign Agreement"
On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"
- It will now display your Trading Partner ID. Please write this down to give to your ClaimShuttle representative during setup/testing
Next, check the box for your Jurisdiction/Line of business
Please press Continue on the Mock Agreements screen
Please re-enter your Tax ID and Group/Billing NPI
- No need to enter rendering NPI's, only the Group/Billing is required
Please enter Contact, Business, and Mailing information then press "Next"
Once done check the boxe(s) next to "I Agree" then press "Done>> Sign Select Agreements"
Click "Complete and Submit" on the right to submit your entire application
Please click "No Thanks, I'm Done" once your submission is complete

Electronic Remittance Advice (835's)

If you need electronic remittance advice, please call WPS directly for assistance completing the form as it can only be obtained via their Provider portal which we do not have access to.

Testing

Once you have completed the enrollment steps outlined above and have your Submitter ID, Community Manager Login ID, and Community Manager Password, please call ClaimShuttle at 602-439-2525 to complete the mailbox setup and test submission. Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.

Once testing is complete, the "Line of Business/Transaction Production Approval Form" must be completed in order to obtain production approval. We will assist you with completing and submitting this form once the test batch has been submitted.

You will receive an email within 3-5 business days stating whether production approval has been granted or denied. Once you have been granted production approval you will need to contact your ClaimShuttle Support Representative so they can finish the setup and assist with your first production batch. If you have any issues with enrollment for claims or remits please feel free to give us a call at 602-439-2525. You can also reach out to WPS directly at 1-866-518-3285.

Page Category:

Direct

Medicare

Veterans Affairs VA Program (via Availity)

cneely — Fri, 23 Feb 2018 17:59:57 +0000

Veterans Affairs claims can be sent via the Availity Clearinghouse. Please click this link to access the instructions for enrolling with Availity. If you have any questions, please call us at 602-439-2525.

Page Category:

Direct

J8 WPS: Michigan Medicare

cneely — Fri, 23 Feb 2018 17:54:27 +0000

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 8, which includes Michigan. If you are a provider located in Jurisdiction 8 and need to become an electronic Submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

Initial Enrollment (Claims)

Please click the following link to begin registration: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml

Click "Enroll", click the CAPTCHA then press "Continue"
Click "Enroll Now" under Providers if you are a healthcare provider

- If you are a Billing Service please give us a call at 602-439-2525 for assistance registering
Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)
Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)
- You can only register for one transaction at a time. We recommend starting with claims, then going back later to turn on remits (835's)
On the next screen, please select "I Don't use a clearinghouse/billing agency"
Click "Register Now" to begin registration for a WPS Community Manager account
On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"
In the new tab that opens, please click "Start Registering"
Next, please enter your company name with no unnecessary symbols (exclude commas and periods)
Please enter your email address
Enter the Captcha displayed for security purposes then click "Next"
On the following screen please enter your company address, phone, fax and email
Do not enter anything for web URL
Please enter the primary legal and support contact information then press "Next" to continue
For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"
Review the Registration Summary for accuracy then click "Confirm and Submit"
You should receive an email confirming they have received your request and it is pending approval
- Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager
- Please click the link and set your password with the following requirements:
  - Exactly 9 characters long with at least one upper case, lower case, a number and a symbol
  - Please keep this information as it will need to be given to your SolAce representative after you finish registration
- If you do not get the subsequent email, please call SolAce for assistance setting your Community Manager Password
You can now go back to EDI Express enrollment to finish registration
Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"
- If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"
If necessary, re-enter the email and press "Continue Enrollment"
Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info
On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement
Electronically sign the agreement by entering your name and pressing "Sign Agreement"
On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"
- The screen will now display your Trading Partner ID. Please write this down to give to your SolAce representative during setup/testing
Next, check the box for your Jurisdiction/Line of business
Please press Continue on the Mock Agreements screen
Please re-enter your Tax ID and Group/Billing NPI
- No need to enter rendering NPI's, only the Group/Billing is required
Please enter Contact, Business, and Mailing information then press "Next"
On the EDI Registration Summary page, if you want to also sign up for Electronic Remittance Advice (ERA's), click "Add Transaction"
- Select 5010 835 Remit Outbound
- Re-enter your company's Tax ID and Billing/Group NPI
- Enter today's date for the effective date then press "Next"
- Click "Use this Data
Please check the box to "Agree", then Sign, and e-sign the agreement
If you have added multiple transactions you will need to repeat this step
Once done, check the boxes next to "I agree" then press "Done>> Sign Selected Agreements"
Click "Complete and Submit" on the right to submit your entire application
Please click "No Thanks, I'm Done" once your submission is complete

Electronic Remittance Advice (835's)

If you need electronic remittance advice, please call WPS directly for assistance completing the form as it can only be obtained via their Provider portal which we do not have access to.

Testing

Once you have completed the enrollment steps outlined above and have your Submitter ID, Community Manager Login ID, and Community Manager Password, please call SolAce at 602-439-2525 to complete the mailbox setup and test submission. Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.

Page Category:

Direct

Medicare

J8 WPS: Indiana Medicare

cneely — Fri, 23 Feb 2018 17:52:45 +0000

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 8, which includes Indiana. If you are a provider located in Jurisdiction 8 and need to become an electronic Submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

Initial Enrollment (Claims)

Please click the following link to begin registration: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml

Click "Enroll", click the CAPTCHA then press "Continue"
Click "Enroll Now" under Providers if you are a healthcare provider

- If you are a Billing Service please give us a call at 602-439-2525 for assistance registering
Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)
Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)
- You can only register for one transaction at a time. We recommend starting with claims, then going back later to turn on remits (835's)
On the next screen, please select "I Don't use a clearinghouse/billing agency"
Click "Register Now" to begin registration for a WPS Community Manager account
On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"
In the new tab that opens, please click "Start Registering"
Next, please enter your company name with no unnecessary symbols (exclude commas and periods)
Please enter your email address
Enter the Captcha displayed for security purposes then click "Next"
On the following screen please enter your company address, phone, fax and email
Do not enter anything for web URL
Please enter the primary legal and support contact information then press "Next" to continue
For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"
Review the Registration Summary for accuracy then click "Confirm and Submit"
You should receive an email confirming they have received your request and it is pending approval
- Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager
- Please click the link and set your password with the following requirements:
  - At least 15 characters long with at least one upper case, lower case, a number and a symbol
  - Please keep this information as it will need to be given to your SolAce representative after you finish registration
- If you do not get the subsequent email, please call SolAce for assistance setting your Community Manager Password
You can now go back to EDI Express enrollment to finish registration
Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"
- If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"
If necessary, re-enter the email and press "Continue Enrollment"
Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info
On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement
Electronically sign the agreement by entering your name and pressing "Sign Agreement"
On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"
- The screen will now display your Trading Partner ID. Please write this down to give to your SolAce representative during setup/testing
Next, check the box for your Jurisdiction/Line of business
Please press Continue on the Mock Agreements screen
Please re-enter your Tax ID and Group/Billing NPI
- No need to enter rendering NPI's, only the Group/Billing is required
Please enter Contact, Business, and Mailing information then press "Next"
On the EDI Registration Summary page, if you want to also sign up for Electronic Remittance Advice (ERA's), click "Add Transaction"
- Select 5010 835 Remit Outbound
- Re-enter your company's Tax ID and Billing/Group NPI
- Enter today's date for the effective date then press "Next"
- Click "Use this Data
Please check the box to "Agree", then Sign, and e-sign the agreement
If you have added multiple transactions you will need to repeat this step
Once done, check the boxes next to "I agree" then press "Done>> Sign Selected Agreements"
Click "Complete and Submit" on the right to submit your entire application
Please click "No Thanks, I'm Done" once your submission is complete

Electronic Remittance Advice (835's)

If you need electronic remittance advice, please call WPS directly for assistance completing the form as it can only be obtained via their Provider portal which we do not have access to.

Testing

Page Category:

Direct

Medicare

J5 WPS: Missouri Medicare

cneely — Fri, 23 Feb 2018 17:51:29 +0000

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 5, which includes Missouri. If you are a provider located in Jurisdiction 5 and need to become an electronic Submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

EDI Enrollment

Please click the following link to begin registration: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml

Click "Enroll", click the CAPTCHA then press "Continue"
Click "Enroll Now" under Providers if you are a healthcare provider

- If you are a Billing Service please give us a call at 602-439-2525 for assistance registering
Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)
Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)
On the next screen, please select "I Don't use a clearinghouse/billing agency"
Click "Register Now" to begin registration for a WPS Community Manager account
On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"
In the new tab that opens, please click "Start Registering"
Next, please enter your company name with no unnecessary symbols (exclude commas and periods)
Please enter your email address
Enter the Captcha displayed for security purposes then click "Next"
On the following screen please enter your company address, phone, fax and email
Do not enter anything for web URL
Please enter the primary legal and support contact information then press "Next" to continue
For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"
Review the Registration Summary for accuracy then click "Confirm and Submit"
You should receive an email confirming they have received your request and it is pending approval
- Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager
- Please click the link and set your password with the following requirements:
  - At least 15 characters long with at least one upper case, lower case, a number and a symbol
  - Please keep this information as it will need to be given to your ClaimShuttle representative after you finish registration
  - If you do not get the subsequent email, please call ClaimShuttle for assistance setting your Community Manager Password
You can now go back to EDI Express enrollment to finish registration
Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"
- If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"
If necessary, re-enter the email and press "Continue Enrollment"
Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info
On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement
Electronically sign the agreement by entering your name and pressing "Sign Agreement"
On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"
- It will now display your Trading Partner ID. Please write this down to give to your ClaimShuttle representative during setup/testing
Next, check the box for your Jurisdiction/Line of business
Please press Continue on the Mock Agreements screen
Please re-enter your Tax ID and Group/Billing NPI
- No need to enter rendering NPI's, only the Group/Billing is required
Please enter Contact, Business, and Mailing information then press "Next"
Once done check the boxe(s) next to "I Agree" then press "Done>> Sign Select Agreements"
Click "Complete and Submit" on the right to submit your entire application
Please click "No Thanks, I'm Done" once your submission is complete

Electronic Remittance Advice (835's)

If you need electronic remittance advice, please call WPS directly for assistance completing the form as it can only be obtained via their Provider portal which we do not have access to.

Testing

Page Category:

Direct

Medicare

J5 WPS: Kansas Medicare

cneely — Fri, 23 Feb 2018 17:49:59 +0000

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 5, which includes Kansas. If you are a provider located in Jurisdiction 5 and need to become an electronic Submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

EDI Enrollment

Please click the following link to begin registration: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml

Click "Enroll", click the CAPTCHA then press "Continue"
Click "Enroll Now" under Providers if you are a healthcare provider

- If you are a Billing Service please give us a call at 602-439-2525 for assistance registering
Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)
Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)
On the next screen, please select "I Don't use a clearinghouse/billing agency"
Click "Register Now" to begin registration for a WPS Community Manager account
On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"
In the new tab that opens, please click "Start Registering"
Next, please enter your company name with no unnecessary symbols (exclude commas and periods)
Please enter your email address
Enter the Captcha displayed for security purposes then click "Next"
On the following screen please enter your company address, phone, fax and email
Do not enter anything for web URL
Please enter the primary legal and support contact information then press "Next" to continue
For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"
Review the Registration Summary for accuracy then click "Confirm and Submit"
You should receive an email confirming they have received your request and it is pending approval
- Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager
- Please click the link and set your password with the following requirements:
  - At least 15 characters long with at least one upper case, lower case, a number and a symbol
  - Please keep this information as it will need to be given to your ClaimShuttle representative after you finish registration
  - If you do not get the subsequent email, please call ClaimShuttle for assistance setting your Community Manager Password
You can now go back to EDI Express enrollment to finish registration
Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"
- If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"
If necessary, re-enter the email and press "Continue Enrollment"
Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info
On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement
Electronically sign the agreement by entering your name and pressing "Sign Agreement"
On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"
- It will now display your Trading Partner ID. Please write this down to give to your ClaimShuttle representative during setup/testing
Next, check the box for your Jurisdiction/Line of business
Please press Continue on the Mock Agreements screen
Please re-enter your Tax ID and Group/Billing NPI
- No need to enter rendering NPI's, only the Group/Billing is required
Please enter Contact, Business, and Mailing information then press "Next"
Once done check the boxe(s) next to "I Agree" then press "Done>> Sign Select Agreements"
Click "Complete and Submit" on the right to submit your entire application
Please click "No Thanks, I'm Done" once your submission is complete

Electronic Remittance Advice (835's)

If you need electronic remittance advice, please call WPS directly for assistance completing the form as it can only be obtained via their Provider portal which we do not have access to.

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