New Electronic Data Interchange (EDI) Forms
In our efforts to continuously improve our products and services, we have revised our forms that are needed to send and receive files electronically. Forms that have been removed are the Data Transmission Questionnaire (DTQ) Form for Electronic Claim Filing (EMC) and Electronic Remittance Advice Processing (ERA), the Authorization to Add Providers for EMC and/or ERA, and the Authorization to Switch from Connect Mailbox to VisionShare for EMC and/or ERA. In addition to this, we added the WPS Authorization form for Electronic Remittance Advice Processing, the Request to Deactivate Electronic Remittance, and we updated the EDI Enrollment Form.
Providers may access the new forms by clicking on the following link:
http://www.wpsmedicare.com/part_a/business/emc837.shtml
We will only accept the previous version of these forms until November 15, 2008. Older forms that are received after that date will not be processed.
** Please note, if you have all ready submitted an EDI form, it will not be necessary to submit another one. **
If you have any questions regarding this change, please do not hesitate to contact our department at 866-734-6656.
Page Last Updated: Thursday, 18-Mar-2010 05:48:59 CDT
