EDI Certification Notices and Forms


ATTENTION PROVIDERS AND SUBMITTERS OF ELECTRONIC CLAIMS: The deadline for receiving the 2019 Annual Certification Forms is December 31, 2018. If you have not submitted a Certification Form for your submitter number (beginning with 450), immediate action is required. Submitters who do not submit the required form will be deactivated February 1, 2019. Providers should verify with their submitter that this requirement has been met to ensure no delays in claims payment.

Submitters must mail the Annual Certification Forms to DXC Technology at the following address:

DXC Technology - EDI Department
PO Box 91025
Baton Rouge, LA 70821-9025

ATTENTION: Providers and Submitters of Electronic Claims – Urgent Message

2019 Annual EDI Certification Letter

2019 EDI Annual Certification Form

2019 Magellan Annual Certification Form

2019 Prepaid EDI Annual Certification Form

2019 Dental EDI Annual Certification Form

ATTENTION: Providers and Submitters of Electronic Claims—Urgent Message

Attention Users of the 5010 837P Claim Transaction

ATTENTION PROVIDERS AND SUBMITTERS OF ELECTRONIC CLAIMS

EDI Submitter Self-Test System Maintenance

Read the Frequently Asked Questions memo before contacting EDI for help.

Please refer to the EDI Certification Notices and Forms Archive page for forms from previous years.

5010 EDI General Companion Guide  5/25/17