Step 4: Complete Your EDI Agreement Form

EDI Agreement

Before submitting your claims electronically you must sign a provider agreement form and return the original or fax a copy of the form to the EDI department. If you have elected to use a clearinghouse to submit your claims, you will still need to complete the EDI provider agreement.  Once we have processed your form, we will contact you and your clearinghouse/billing service (if this is a chosen option) with approval to begin submitting test or production files.  It is normally not required to test when submitting through an approved clearinghouse.  These forms can be found on this page or within WTPS.