Get Tn Tdh Edi Packet Instructions

Completing the TN TDH EDI Packet is essential for trading partners wishing to engage in electronic business with the Tennessee Department of Health. This guide provides step-by-step instructions to help users fill out the necessary forms accurately and efficiently.

Follow the steps to complete the TN TDH EDI Packet successfully.

1. Click ‘Get Form’ button to obtain the form and open it for editing. Ensure you have the necessary documents ready before proceeding.
2. Complete the Trading Partner Agreement. Fill in the required information on page 1 and ensure you sign and date page 7. If you are the one submitting your electronic billings, you will also be the EDI Submitter and only fill out pages 1 and 2 of the EDI Submitter.
3. If a clearinghouse is submitting on your behalf, ensure they complete page 3 of the EDI Submitter and sign the Certification. All completed and signed pages should be included when returning the EDI Packet.
4. Complete the TDH EDI Request Form (Exhibit II). Fill in the Trading Partner Information, indicating if this is a NEW or REVISED registration form. Ensure to provide details for a contact person and specify the primary submission method, encryption, and transaction versions.
5. Fill out the section indicating the transactions you or your EDI Submitter are authorized to conduct electronically. Make sure to sign and date the form after completing all fields.
6. Complete the TDH Security Form (Exhibit III) by providing the requested information on pages 1 and 2. Don't forget to sign and date both pages.
7. Make copies of all forms, including the Trading Partner Agreement, EDI Submitter, TDH EDI Request Form, and TDH Security Agreement for your records.
8. Send the entire EDI Packet with original signatures to the Tennessee Department of Health at the designated address provided in the instructions.

Take action now and complete your TN TDH EDI Packet online to ensure timely processing.