Enrolling with CEDI is easy!

CEDI enrollment documents are completed and submitted on- line. After completing any of the on-line forms below, you must click on the “Submit” button, print, sign, date and fax the form to the number located on the printed form. Do not print the screen before you click on “Submit”.

Submitted enrollment forms will be issued Request ID (RID) numbers which will appear on the printed copy of the form. The RID number can be used to track the submitted form.

IMPORTANT: Forms that are not printed after clicking on “Submit” and/or are not signed, dated, and faxed to CEDI will not be processed.

*NEW* - CEDI Enrollment Interactive Voice Response (IVR) System

The CEDI Enrollment IVR can be used to check the status of submitted enrollment forms 24 hours after the on-line submission. The CEDI Enrollment IVR Guide has been provided to assist in using the IVR which can be reached at 1-866-311-9184 Option 2.

Enrollment Forms and Instructional Guides	Complete for:
CMS EDI Enrollment Form Instructional Guide	Every New DME MAC Electronic Trading Partner (If you do not already have an existing Sender or Submitter ID, please complete the Submitter Action Request Form along with the EDI Enrollment form.)
	Trading Partners to add a new PTAN/NSC or NPI number to an existing Submitter ID
Supplier Submitter Action Request Form Instructional Guide	Every new DME MAC Electronic Trading Partner (Must also complete the CMS EDI Enrollment Form)
	Ordering the PC-ACE Pro32 Software Program (Check box included on the form, under Section II - SOFTWARE VENDOR)
	Existing Trading Partners to:
	• Request the addition of a new transaction
	• Changing a file transfer option
	• Changing software vendors
	• Update contact information
Supplier Authorization Form Instructional Guide	Suppliers using a Clearinghouse, Billing Service or other Third Party to exchange any transactions with CEDI (This includes claims, ERAs and 276/277 transactions.)
	Existing Trading Partners changing to a Clearinghouse, Billing Service or Third Party Biller
Address and Contact Information Change Form	Trading Partners who wish to update the address or contact information associated with the Submitter ID
	This form will only update the address and contact information on file with CEDI
	Used by existing Trading Partners

When CEDI forms are submitted, an acknowledgment email will be generated and sent back to the email address entered on the form. Once the request has been approved and processed, a setup confirmation will be sent via email. For security purposes, confirmation of enrollment requests for a new Trading Partner (Submitter) ID requiring a password will be sent in two emails. The Trading Partner (Submitter) ID and connectivity information will be included in the first email and the password will be sent in the second email. If an email address is not provided on the forms or if the email is returned as undeliverable, CEDI will respond with the setup confirmation via fax or mail.

The initial password is a default password which will expire immediately and requires the user to establish a confidential, unique password. Passwords will expire every 90 days. Password configuration requirements are as follows:

1. Passwords must be eight (8) characters in length. No more and no less.
2. Passwords must contain a combination of number and alpha characters.
3. Passwords must contain a special character, for example (@, #, $).
4. Passwords are only good for 90 days, at which time the user must reset it.
5. Passwords cannot be changed by the user more than once per day.
6. After three incorrect login attempts, the ID will be revoked. Please disconnect and re-try prior to the third attempt.
7. The ID history retains the last 12 passwords the user has used. These cannot be reused.
8. Must not be stored in scripts, files, or applications unless compensating controls are in place

Note: Trading Partner IDs will automatically suspend after 365 days of inactivity

Note: CMS strictly prohibits any trading partner from outsourcing system functions overseas, unless explicitly authorized, in writing, by the CMS CIO. Any request for access by an overseas party must be immediately denied by National Government Services pending authorization from CMS. Because many of our forms do not ask for an address for a 3rd party, please verify other information like a phone number to ensure it is not an international exchange.

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