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  • Posting Date: 07/22/2016
    Part A Logon Request Form: Billing Service Using a Letter of Authorization PIN

    Part A Logon Request Form  Billing Service Using a Letter of Authorization PIN This option allows a billing service to complete the Part A Logon Request Form after the Letter of Authorization has been completed by the provider/facility [...]

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  • Posting Date: 07/22/2016
    Entry Process Questions

    Entry Process Questions I need to complete a Logon Request Form This option is used for a provider/facility to request/modify access to the Part A FISS/DDE system. (EDI Enrollment Agreement is included within this packet if needed.) [...]

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  • Posting Date: 07/22/2016
    EDI ERA Enrollment Form

    EDI ERA Enrollment Form The EDI ERA Enrollment Form is required to be on file for each PTAN/NPI currently setup or requesting to be setup for the first time to receive electronic remittances through NGS. Should I Complete This Form? The [...]

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  • Posting Date: 07/22/2016
    Part A Logon Request Form: Provider/Facility Requesting Access

    Part A Logon Request Form Provider/Facility Requesting Access This form is for Part A providers requesting access to the Fiscal Intermediary Standard System (FISS)/Direct Data Entry (DDE) Online System and check patient eligibility. Note: Up [...]

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