The Department's fiscal agent EDI Services offers technical assistance to providers who electronically submit Colorado Medical Assistance Program claims. This assistance includes:
- Enrolling providers in Electronic Claims Submission and Report Retrieval
- Providing technical assistance to Billing Agents, Clearinghouses, and Software Vendor
- Providing assistance with Submitter testing
- Identifying and troubleshooting technical problems
- Verifying claim receipt
Our Support Unit can provide you with detailed information that will make your transition to an electronic environment an easy one. EDI Support is available Monday through Friday, 8:00 a.m. - 5:00 p.m. at 1-800-237-0757 (toll free).
EDI X12N Transaction Forms
Download, complete and submit all pages of the Provider Application for EDI Enrollment. Providers should follow the instructions carefully to avoid EDI processing delays.
After processing, EDI Services will fax or mail your trading partner information to you. The State will follow-up on the enrollment process and send you the necessary user names and passwords for accessing the Web Portal.
EDI Submitter Enrollment Form (04/15)
All switch vendors that submit electronic transactions to the Colorado Medical Assistance Program are required to complete the Switch Vendor Submitter Enrollment Application (04/15). Please download, complete and submit the application to the address on the last page of the application.
Providers already enrolled for EDI
- Provider EDI Update Form - Please use this form to update previously submitted EDI enrollment information. The form can be electronically or manually completed, printed and mailed.
- Termination of Trading Partner ID Form - Please complete and submit this form if you no longer want or need access to the Colorado Web Portal.
DSH EDI Documents
- To avoid delays in enrollment processing, please click on the Submitter and Enrollment link listed below and print and complete the document.
- To update previously submitted DSH EDI enrollment information, please click on the Update form link listed below and print and complete the document.
- DSH EDI Submitter Enrollment and Agreement (04/15)
- DSH EDI Update Form (04/15)
- Hospital Provider Authorization Form (04/15) - This is a copy of page 8 in the DSH EDI Submitter Enrollment and Agreement. This form must be completed and signed by each hospital authorizing a clearinghouse or other submitting hospital provider to access information on an authorizing hospital provider's behalf.
- DSH Frequently Asked Questions and Answers - This document contains frequently asked questions and answers about DSH enrollment and DSH enrollment forms.
Please mail completed DSH EDI forms to:
DSH EDI Enrollment
Colorado Medical Assistance Program
DSH EDI Submitter Services
P.O. Box 1100
Denver, CO 80201-1100