Getting Started with EDI Support Services
This page informs providers of the steps to begin sending healthcare data electronically through EDI Support Services (EDISS). Electronic Data Interchange (EDI) provides several benefits to providers. For more information on the benefits of EDI, click here. To view CMS EDI instructions via the CMS website, click here.
- Register in Total OnBoarding (TOB)
- Confirm the primary email address
- Manage NPI and Lines of Business
- Select Vendors
- Manage Transactions
- Complete Enrollment Forms (if applicable)
- Complete the Digital Certificate Process (if applicable)
- Complete the Testing Process (if applicable)
This is the initial account creation in TOB; where basic demographic information is collected and users will set-up a login and password for their TOB account. If a facility is registered with EDISS for electronic transactions their registration information has been auto-loaded into TOB. The registration process will vary for this user type.
Steps in registration include:
A. Creating a New User Account
B. Selecting Account Type (i.e., Provider, Vendor, Additional Access)
C. Adding or Updating Contact Information
D. Reading and Accepting TOB Agreements
E. Creating a User name and Password for Account access for TOB
A confirmation email generates to the primary email address within minutes of the account creation. Complete the instructions in this email to confirm that e-mail address. Confirming the e-mail address assures further delivery of TOB e-mails.
New EDISS providers need to enter the billing NPI(s) and choose the associated states (regions) for their profile. This may be the state in which your practice is located.
Existing EDISS providers are auto-loaded into TOB and their NPI(s) is already on their profile. Confirm that the auto-loaded NPI(s) and regions are accurate.
New EDISS providers will select a Vendor if they are using a Clearinghouse or Billing Service. If claims are sent directly to EDISS no vendor selection is required.
Existing EDISS providers are auto-loaded into TOB and their Vendors are already on their profile. Confirm that the auto-loaded Vendor is accurate.
Note: Vendors must be HIPAA compliant. EDISS provides a list on the EDISS website of HIPAA compliant vendors currently in production. To view the list, click here.
New EDISS providers select the transactions associated to each NPI in their profile. The available transactions are dependent on the region selected on the profile.
To select transactions click the NPI on the profile. The screen for transaction selection appears. If the profile contains more than one NPI each NPI will have to be updated separately.
Existing EDISS providers are auto-loaded into TOB and their transactions are already on their profile. Confirm that the auto-loaded transactions are accurate.
Note: For any direct transaction, a software vendor needs to be selected. If PC-ACE Pro32 is chosen as the software, a PC-ACE Service Agreement appears.
For some Lines of Business an enrollment form is required. Enrollment forms should be faxed to EDISS.
Users who have a direct transaction that requires testing with EDISS must complete the Identity Validation Form process to obtain a Digital Certificate. For more information on what a Digital Certificate is, visit the FAQ page found in TOB.
EDISS requires all Trading Partners to test their electronic health care claim transactions through TOB before being granted production status. The testing process verifies the format and structural accuracy of the electronic claim file sent by a Trading Partner. If a Billing Service or Clearinghouse sends claims on a provider’s behalf, that vendor tests for the provider.
Some Billing Services and Clearinghouses have applied for Blanket Approval and may not have to test; this accelerates the process of being granted production status. Click here for the Blanket Approval guidelines and procedures. For more information on the TOB testing process view the FAQ page in TOB.
The steps above are outlined in the Total OnBoarding (TOB) User Guides and Online Tutorials located on the Total OnBoarding tab of our website.