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EDI Enrollment Form Instructions Section 1 Section 3 Trading Partner Information: Trading Partner Number - Organization Name - Mailing Address - City, State, Zip - Contact Name(s) - Telephone # -.

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BCBSKC Related content

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Emdeon or Office Ally (See Section H3 of the manual for details) Hard Copy Claims:...
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How much does Office Ally cost? Office Ally is free to use. There are no setup fees, monthly fees, or per-claim fees for electronic claims submission to Participating Payers. Users have the option of purchasing EHR 24/7, which costs $29.99 per month.

Office Ally software allows providers to create, submit, and track insurance claims, as well as run reports, check eligibility, and verify codes.

Go to Manage Office> List Maintenance> Staff. Click the “Add New” button. The required fields are marked with a red asterisk (*). After you have entered the staff member's information, click “Add Member.”

If you are a Provider who is credentialed with Medicare, you must complete a pre-enrollment EDI form prior to submitting e-claims through our clearinghouse partner Office Ally.

Click on Correct to view the claim in CMS-1500 format. The claim will display in CMS-1500 format on your screen. Add the required information to correct the claim. Put the resubmission code in Box 22. ... If you received an EOB for the claim, put the original claim number in Box 22 next to the resubmission code.

Creating an Account with Office Ally: TA Electronic Claims... STEP 1: Go to Office Ally's Website. ... Step 2: Complete the online enrollment form. Step 3: Within the 'System Information' section, check the last option, making sure to include our TA website URL.

Input Submitter ID # (if applicable): 837 (for submitting claims): 835 (to receive ERA):

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232