SolAce - Electronic Medical Claims

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter ID's

The following documents are required enrollment documents that must be completed prior to initiation of electronic claims submission or inquiry. Please Copy and Paste the following links into your internet browser’s address bar and click Enter You must use Internet Explorer to complete NGS’s ONLINE FORMS in order to obtain a Submitter ID.

CEDI Enrollment Agreement Form

http://apps.ngsmedicare.com/applications/CEDIEnrollmentAgreement.aspx Click “Accept” on the Attestation page to continue. Complete the parameters on the form

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 Palmetto GBA office prior to initiation of electronic claims submission or inquiry. 1. J1 Palmetto GBA EDI Enrollment Packet To obtain the enrollment forms, please download them from: Link text If you have any questions regarding any of the documents in this package, please call the Palmetto GBA EDI Technology Support Center at 1-866-749-4301.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Process for those applying for new Submitter IDs

Please go to the following link to complete WPS' online Registration Form https://corp-ws.wpsic.com/apps/wtps-web/unauth/RegistrationLoadAction.do

Enter your Business or Provider Name in the Submitter Name field
Enter your Demographic & Contact Information
For To and From Transmission Method, select WGBBS
Check the following boxes:
- Receive Acknowledgement
- Receive Remittance (If you would like to receive electronic EOB's)
For Vendor Name enter: AXIOM Systems, Inc. (formerly Ivertex)
Click Save

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 Novitas Solutions office prior to initiation of electronic claims submission or inquiry. You may need to copy and paste the links below into your web browser’s address bar in order for them to work properly. 1. Novitas Solutions EDI Enrollment Form (8292) 2. Novitas Solutions Vendor Agreement Form (8291) (For Billing Services Only) If the links above do not work properly, please click on the following link: Novitas Solutions Home Page If you have any questions regarding any of the documents in this package, please call the Novitas Solutions EDI Technology Support Center at 1-877-235-8073.

Required Information

We recommend that you have the following information ready before filling out your forms:

Your Submitter Information	Software Vendor Information
Name	Vendor Name - AXIOM Systems, Inc.
Address	Contact - EDI Team
Phone and Fax Numbers	Vendor Code - N/A
E-mail Address	Phone - 602-439-2525
Contact Name	Fax - 602-439-0808
Provider NPI Numbers for this payer	Address - 241 East 4th Street, Suite 200 Frederick, MD 21701
Organization or Group NPI's for this payer	Software Name - SolAce EMC
	E-mail - Support@SolAce-emc.com

New EDI Submitters

Follow these instructions when filling out forms for a new Submitter ID.

Electronic Data Interchange (EDI) Enrollment Form

Section A: Select your Line of Business and State Section B: Enter the name of the Group, Provider, Or Supplier who is applying for a Submitter ID Section C: Enter your Practice’s demographic information Section D: Enter the Provider’s NPI and PTAN Section E: Do not check the box for PC-Ace Pro 32 For name of Software Vendor , enter Axiom Systems, Inc. Formerly Ivertex

If Provider is sending and receiving using SolAce, place check mark next to Provider
If a Billing Service is sending/receiving on behalf of the provider check, Billing Service

Check the last box in this section about your 855 form if applicable Section F: Place a check next to Assign this provider a new electronic billing submitter ID

Select either One Submitter ID or Separate Submitter ID’s per contract, whichever you prefer.

Section G: Skip this section if you do not have an existing submitter ID Section H: Select the box that says “The new submitter ID being requested in block F of this form” Section I: Skip this section Signature Section: Type your Name and Title, then Sign and Date

Novitas Solutions, Inc. Vendor Agreement (Billing Services Only)

Header: Check Billing Service Section I. Enter your Company’s Name, Demographic info, and Contact information

For Name of Software enter SolAce-EMC
Skip the first Box
Check the second box if you wish to not receive paper mail responses.

Section II. Check the box to Assign a new submitter ID.

Select the box that says “I am a Billing Service or Clearinghouse that will be submitting claims directly to Medicare”
Name of Vendor: AXIOM Systems, Inc. formerly Ivertex
Choose either one submitter ID for all Part B contracts or Separate ID’s per contract
- You would probably want Separate ID’s per contract.
Check the box to assign a new ERA Receiver ID if you will be receiving your Provider’s ERAs.

Section III. Check these boxes:

Create ANSI ASC X12N 837 claim files in the following version: Check box for 5010
Retrieve ANSI ASC X12N 835 remittance files in the following version: Check box for 5010
Provide the following type of connection to Novitas Solutions: Check box for FTP and Dial Up
- You may also select DDE and PPTN. Ask us about our ClaimShuttle Network Service today so we can get you access to the DDE or PPTN screens that you need to access!
Provide services to the following contracts: Check applicable boxes for Part A, and/or Part B

Section IV. Skip this section Signature Section: Print your Name and Title, then Sign and Date this application

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:

Novitas Solutions, Inc. EDI Department P.O. Box 890011 Camp Hill, PA 17089-0011 Or Fax to: 1 (877) 439-5479

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 mailed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Novitas Solutions EDI Technology Support Center at 1-877-235-8073

Testing

Once you have received your Submitter ID and Password from Novitas Solutions, please call the SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission to Novitas Solutions. 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.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 Palmetto office prior to initiation of electronic claims submission or inquiry.

J11 Palmetto GBA EDI Enrollment Packet

To obtain the forms above, please download them from: http://www.palmettogba.com/Palmetto/Providers.Nsf/files/EDI_Enroll_J11_Pack.pdf/$File/EDI_Enroll_J11_Pack.pdf

Palmetto GBA administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction J, which includes the state of Tennessee. If you are a provider located in the state of Tennessee and need to become an electronic submitter for your Medicare A/B claims, please follow the instructions below.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 PGBA office prior to initiation of electronic claims submission or inquiry. 1. Clearinghouse/Direct Submitter Trading Partner Agreement (Fill out this form if you will be sending claims directly to Tricare) http://www.mytricare.com/Internet/tric/tri/imglib.nsf/(WebFiles)/F0016397A84B8BC285257A0200683907/$FILE/Clearinghouse%20Direct%20Submitter%20Trading%20Partner%20Agreement%20Revised%2004%202012.pdf

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter ID's.

The following documents are required enrollment documents that must be completed, signed and returned to the First Coast office prior to initiation of electronic claims submission or inquiry. 1. EDI Enrollment Form with Instructions 2. Electronic Data Request (EDR) Form To obtain the forms above, please copy the link below into a new tab or browser, and select your state and line of business: http://medicare.fcso.com/EDI_Forms/ If you have any questions regarding any of the documents in this package, please call First Coast EDI Technology Support Center at 1-888-670-0940, option 4.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

Required Documents for those applying for new Submitter IDs

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI). All providers must first register for Noridian’s Total Onboarding System in order to become an electronic submitter. Guides can be found at http://www.edissweb.com/cgp/forms/onboard.html Once you have established your Total On Boarding Account, please log into your account.

On the first page, click the “Manage NPIs” button and choose your billing NPI.
Select the transaction types you want to enroll your Billing NPI for:
- For Professional claims, click “Enroll” for 837P (5010A1)
- For Institutional claims, click “Enroll” for 837I (5010A1)
- To receive your EOBs electronically, click “Enroll” for 835 (5010A1)

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customer Testimonial

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.

Shani Madaminova,
Administrator
Best Home Care, Inc
Jersey City, NJ

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.

Susie Doran Carter, Westcare Management, Inc.
LTC Medicare Consultant and Billing Service
Salem, OR

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.

Carolyn Boles
From the office of Donald J. Boles Jr. MD PC
Tempe, AZ

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.

S. Bowling
Idabel, Oklahoma

Easy to use, Customer support has always been excellent, Thanks SolAce Team.

Carl Shepherd
IT Administrator
THE WYNN GROUP, INC
Dublin, GA

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.

Denise
Margate, FL

Awesome customer service every time!

Denise
Bellevue, NE

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!!

Doreen
Bemidj, MN

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.

George
Mahornet, IL

The follow-up is outstanding - whenever there is an issue I am contacted to be sure that all is working well and to my satisfaction.

Joan
Batavia, IL

Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.

Patricia
Orlando, FL

Tech was very helpful, very patient and very professional. She knew of the issue quickly and stayed at hand until issue was resolved. Very satisifed with the service.

Sherry
Largo, FL

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Enrollment Instructions

Required Documents for those applying for new Submitter ID's

CEDI Enrollment Agreement Form

Enrollment Instructions

Required Documents for those applying for new Submitter IDs

Enrollment Instructions

Required Process for those applying for new Submitter IDs

Enrollment Instructions

Required Documents for those applying for new Submitter IDs

Required Information

New EDI Submitters

Electronic Data Interchange (EDI) Enrollment Form

Novitas Solutions, Inc. Vendor Agreement (Billing Services Only)

Submitting your Forms

Waiting for a Response

Testing

Enrollment Instructions

Required Documents for those applying for new Submitter IDs

Enrollment Instructions

Required Documents for those applying for new Submitter Ids

Enrollment Instructions

Required Documents for those applying for new Submitter ID's.

Enrollment Instructions

Required Documents for those applying for new Submitter IDs

Enrollment Instructions

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