Get Edi Services Part B Vendor Application - Cahaba Gba

The EDI Services Part B Vendor Application by Cahaba GBA is an essential document for vendors seeking to provide electronic data interchange services. This guide will help you understand the steps to complete the application online accurately and efficiently.

Follow the steps to complete the application seamlessly.

1. Press the ‘Get Form’ button to acquire the form and open it in your preferred editor.
2. Begin by providing your general information. You will need to specify what you wish to update from the options provided, such as software status or contact information.
3. Next, enter your company information, including your business name, tax ID, previous business name (if applicable), and website. Make sure to include your contact number and fax number along with your mailing address, city, state, and ZIP code.
4. Proceed to fill out the technical contact information. This includes the name of the person responsible for technical communications, their phone number, mailing address, fax, email, city, state, and ZIP code.
5. In the marketing contact information section, provide details of the marketing contact. Include their name, mailing address, city, phone number, fax, email, state, and ZIP code.
6. Fill in the software information. Specify the software name and its corresponding supported formats, including whether you support ANSI 837 Claim Format, ANSI 835 Remit Format, and ANSI 276/277 Claim Status. Also, indicate the software version.
7. Once all fields are correctly filled out, review the application for accuracy. You can then save your changes, download a copy, print it for physical submission, or share it as required.

Ensure you complete your application online to streamline the process and enhance efficiency.