- General Information
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Submitter Type - Provider
- Submitter Type - Provider
- I Am a Provider and “I Want to Connect Directly to the Part A FISS/DDE System”
- I Am a Provider and “I Want to Allow a 3rd Party Billing Service to Bill for Me Using the Part A FISS DDE System”
- I Am a Provider and “I Want to Complete an EDI Registration Form”
- I Am a Provider and “I Want to Complete a Connex Registration Form”
- Submitter Type - Billing Service
- Submitter Type - Clearinghouse
Selecting the Submitter Type
Each submitter type includes a description and the available tasks that can be completed for each.
There are three submitter types:
- Provider – The provider of service.
- The Authorized or Delegated Official is required to sign this form.
- Billing Service - A Billing Service collects a providers claim information and then bills the appropriate insurance companies, including Medicare.
- Clearinghouse - A Clearinghouse transfers or moves EDI transactions for a provider or Billing Service, and generally translates the EDI transactions from or into a proprietary format. They cannot alter information in any way.
Select one submitter type and click, Next.
Note: Click anywhere inside the description box to make a selection.