Rhode Island Medicare Services: Download EDI Specs and Software

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EDI Download File Center

The following EDI items are currently available for download from our web site.

Medicare Software and Forms
Forms must be completed and return to Medicare Services via routine mail with original signatures.

	Provider Enrollment Status Request/Inquires	In an effort to better serve our customers with enrollment questions this form can be completed and returned to: edi@arkbluecross.com, or faxed (501)378-2265.
ANSI 4010A1 276 / 277 Claim Status Inquiry Enrollee Information Form		These pages should be completed to begin your enrollment for the electronic transmission of ANSI 4010A1 276 / 277 Claim Status Inquiry or to update your current EDI profile for Claim Status Inquiry. Questions should be directed to the EDI Service Line at 866-582-3247.
ANSI 4010A1 Specialty Testing Form		This form should be used to schedule a ANSI 4010A1 Test.
Asynchronous Communications - Hyperterminal
Electronic Funds Transfer (EFT) Form		This link will take you to the CMS web site where the EFT form may be downloaded. The completed form should be mail to: Pinnacle Medicare Services Attn: Provider Enrollment P.O. Box 34260 Little Rock, AR 72203
EDI Enrollment Form
Electronic Remittance Advice (ERA) Form
Financial Intermediary Shared System (FISS) User Access Request Form		All users who wish to have access to the FISS system must complete the following information.
Letter Of Authorization		This document is for the purpose of authorizing someone other than the Provider to access Medicare Systems on the Provider’s behalf.
Medicare Claims Transmissions Software		This page includes information and links to HIPAA Compliant Software which is available to facilitate Medicare claims transmissions.
Medicare Remit Easy Print (MREP)		The Medicare Remit Easy Print Software (MREP) is a software product developed for the Centers for Medicare & Medicaid Services (CMS). The MREP is a software product that allows viewing and printing of X12 835 4010A1 electronic remittance advices for Medicare Part B. This software does not support systematic posting of the 835 remittance.
MREP User Guide		Installing and Using Medical Remit Easy Print
NPI Information
Provider Enrollment Status Request/Inquires		In an effort to better serve our customers with enrollment questions this form can be completed and returned to: edi@arkbluecross.com, or faxed (501)378-2265.
Report User Guide		This document was created to provide detail instructions on how to analyze the reject reports.
Submitter Information Update Form
Trading Partner Agreement
X12N Transaction User Guide		The X12 Transaction User Guide provides you with information regarding HIPAA standard electronic transactions in the American National Standards Institute (ANSI) Accredited Standards Committee (ACS) X12N.

ANSI ASC X12N 4010 Specifications and Implementation Guides

ANSI ASC X12 Guides may be downloaded at http://www.wpc-edi.com/

PrePass Edits

ANSI X12 837 V4010 Prepass Edits