New York Medicaid: eMedNY
Please follow the Enrollment Instructions below to become an electronic submitter for New York Medicaid.
Required Documents for those applying for new Submitter IDs
The following documents are required enrollment documents that must be completed, signed and returned to the EMedNY office prior to initiation of electronic claims submission or inquiry.
Note: You may be required to use Internet Explorer to open the links listed below.
1. Provider ETIN Application
(If you would rather fill out the Electronic Remittance Advice Form online, you can do so within the Provider Portal)
If the links listed above do not work properly, please download these forms from:
If you have any questions regarding any of the documents in this package, please phone the EMedNY EDI Technology Support Center at 1-800-343-9000 option 2.
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.
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|
Provider Electronic Transmitter Identification Number (ETIN) Application
- Please Provider's Name and Address
- Please the name of the Administrator in your office
- Please enter the Main Contact Person’s Name and Phone
- Enter the Provider’s NPI
- Enter Your Medicaid Provider number
- Print Name and Title, Sign and Date
- New applicant’s please leave the ETIN field blank
- If using a Billing Service, Enter Billing Service’s Name
- Enter the date
- Please enter the Provider’s name
- Please enter the NPI number
- Please enter the Medicaid Provider Number if applicable
- Print Name and Title
- This form must be Notarized, this section is for the notary public to fill out
Mail the Original completed application to:
Computer Sciences Corporation
ATTN: Enrollment Support
PO Box 4614
Rensselaer, NY 12144-8614
***Upon receipt of Submitter ID, Please call NY Medicaid at 1-800-343-9000 option 2 to request a “FTP Logon User ID and Password”***
Billing Agency ETIN Application
- Enter your Billing Agency's Name, Addres, Phone and Fax numbers
- Enter the Adminstrator and Contact information
- Sign and Date
- If you are using this form to obtain an ETIN, leave blank. If you wish to add a provider ID number to an existing ETIN, indicate the ETIN in the top left corner of the form
- Enter the name of the Billing Service
- Enter the Date
- Enter Provider Name, NPI, and Medicaid Provider ID number
- Provider must sign and date this form and enter their contact information
- This must be signed by a Notary Public
Trading Partner Agreement
- Please enter the Provider/Business or Billing Service Name as the "Trading Partner"
- Please enter your name, title, and sign
(Please Note: Please include all pages when submitting this form)
ERA Request Form
(Please fill out this form after receiving your Submitter ID, FTP Logon User ID and Password)
- Enter your Provider Name
- Enter your Tax ID or EIN
- Enter the NPI
- Enter your Medicaid Provider Number if NPI exempt
- Enter your Trading Partner ID (ETIN)
- Enter the Name, Phone, Email, and Fax for the main Contact person in your office
- Check the box for 835
- Check the box for FTP
- Enter your FTP user ID # you were assigned
- Check the box for New Enrollment
- Sign, Date, Print Name and Title
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
Mail the Original completed Documents to:
Computer Sciences Corporation
ATTN: Enrollment Support
PO Box 4614 Rensselaer, NY 12144-8614
Fax the ERA Request Form to: 518-257-4632
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 weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the EMedNY EDI Technology Support Center at 1-800-343-9000 option 2.
Please be advised, ERA Request forms are processed Every Thursday at EMedNY.
Once you have received your Submitter ID and password from EMedNY, please call the SolAce Support Team and set an appointment for a Mailbox setup. ( No Test Transmission is required for EMedNY.)
From our customers
I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.
SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.
I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.
SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.
Easy to use, Customer support has always been excellent, Thanks SolAce Team.
I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.
Awesome customer service every time!
I can't tell you how wonderful it is to work with your agency. They are courteous, knowledgeable,friendly, and a joy to work with - I can't say enough. Thank you!!
The service was very good. Phone answered promptly even though it was around 6 p.m. my time. Very courteous and helpful. So far I have had really good experiences with your support team.
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