Enrolling with CEDI is easy!

Enrollment documents are completed and submitted on-line to CEDI. To comply with CMS requirements, these documents must be printed, signed, and faxed to our electronic fax system. After completing any of the on-line forms below, click on the “Submit” button, print, sign and fax the form to the number located on the printed form.

The two documents below are required and must be completed for  EVERY new DME MAC Electronic Data Interchange (EDI) Trading Partner (Submitter).

• CMS EDI Enrollment Agreement
• Supplier Submitter Action Request Form

The CEDI Submitter Action Request Form is submitted to request the addition of a new transaction. For example, if a supplier is only submitting electronic claims and wants to begin receiving an electronic remittance advice, the CEDI Submitter Action Request form is completed by filling in the requested information and checking the box for the 835 Electronic Remittance Advice (ERA). The form is then faxed to CEDI for processing.

• Supplier Authorization Form

When CEDI forms are submitted, an acknowledgment email will be generated. Once the request has been approved and processed, a confirmation email will be sent. 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 e-mail is not provided on the forms, CEDI will respond via fax or mail.

The 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