- General Information
- Submitter Type - Provider
- Submitter Type - Provider
- I Am a Provider and “I Want to Connect Directly to the Part A FISS/DDE System”
- I Am a Provider and “I Want to Allow a 3rd Party Billing Service to Bill for Me Using the Part A FISS DDE System”
- I Am a Provider and “I Want to Complete an EDI Registration Form”
- I Am a Provider and “I Want to Complete a Connex Registration Form”
- Submitter Type - Billing Service
- Submitter Type - Clearinghouse
Completing the Registration Forms
Complete all required fields marked with an asterisk or you will not be able to proceed with the submission of the form.
The type of registration form and required information is going to vary depending on the submitter type and objective selected in step one and the system selected to connect to in step two of this guided process.