1. Home /
  2. Getting Started with EDI

Getting Started with EDI

This page informs providers of two simple steps to start 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.

Two Simple Steps!
There are two steps to begin sending healthcare data electronically through EDISS. For additional assistance, please contact the EDISS helpdesk at 1-800-967-7902.

STEP ONE: Complete registration through Total OnBoarding (TOB)
TOB is an online registration and testing tool, which replaces the previous paper registration and claim testing processes. For more information on TOB, click here.

TOB enables providers to:

Enter basic facility information (e.g., address, contact e-mail, phone number, etc.)
TOB requires accurate facility information to be entered upon registration. If any information changes, simply log into TOB and update your profile.

Add billing NPI
EDISS requires providers to register their billing NPI’s for electronic transactions. Rendering NPI’s are not required in TOB.

Add appropriate lines of business (LOB)
Any LOB that has electronic transactions must be added to the appropriate NPI.

Select desired electronic transactions for their profile
Depending on the LOB, EDISS supports multiple electronic transactions. Electronic Claim Submission, Electronic Remittances, Claim Status, and Eligibility Benefit Inquiry are a few of the transactions providers may choose from.

Select a HIPAA compliant vendor
EDISS defines a vendor as an entity that provides hardware, software and/or ongoing technical support. There are three types of vendors EDISS works with.

All vendors must be HIPAA compliant. EDISS provides lists of all HIPAA compliant vendors currently in production. Select the link below to view the vendor list.

EDISS HIPAA Compliant Vendor List

For information on what to consider when searching for a vendor, click here.

Complete the Digital Certificate process (if applicable)
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, click here.

For assistance with TOB registration, visit the Total OnBoarding page of our website. The Total OnBoarding page offers links to the TOB User Guides and a direct link to the TOB registration page.

STEP TWO: Complete the Testing Process (if applicable)
The testing process verifies the format and structural accuracy of the electronic claim file sent by a Trading Partner. EDISS requires all providers to test their electronic health care claim transactions through TOB before being granted production status. If providers selected a billing service or clearinghouse to do their billing, the billing service or clearinghouse tests through TOB on the provider’s behalf.

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. To view the Blanket Approval guidelines and procedures, click here.

For more information on the testing process, click here.

Some of the documents located on this page are in PDF format and can be opened in Adobe Acrobat Reader. If you do not already have this application, follow the Get Adobe Acrobat link to download a free copy of the software.