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Welcome
to ACS EDI Gateway, Inc. Trading Partner Agreement Online. ACS EDI Gateway is a business associate to its covered entity clients, as defined in regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In most cases, our client is the State Medicaid Agency. Under contract with our covered entity client, we provide functions and services to receive and send all transactions on behalf of the client from and to providers. These transactions usually include protected health information, as defined under HIPAA. We perform these functions on behalf of the covered entity client, and, therefore, are the business associate of the covered entity. ACS EDI Gateway, Inc. has developed a trading partner agreement and a business associate agreement between the provider/submitter, and ACS EDI Gateway, Inc. as the covered entity. Providers can now submit these agreements online by selecting the appropriate link on the left side of this page. Billing Agents, Clearinghouses and Software Vendors without a provider number must download the appropriate agreement below. Please fax or mail the agreement to ACS EDI Gateway.
Important Agreement Information (Please read)
- EDI Trading Partners must complete and return an EDI Gateway Enrollment Packet along with the appropriate Trading Partner Agreement. To obtain the EDI Gateway Enrollment Packet, please visit the enrollment
page on this web site for your selected payer (s).
- Execute the Trading Partner Agreement (TPA) if you are a provider/submitter sending and/or receiving standard format.
- There is a specific Trading Partner agreement for Mississippi Medicaid providers/submitters. Please click here for Mississippi agreement.
Providers must have a provider number to use this service. EDI Gateway trading partners/submitters without a Provider Number must click on the appropriate link below to download agreement document.
We prefer that you submit your ACS EDI Gateway, Inc. Trading Partner or Trading Partner/Business Associate Agreement online. If you are unable to
access the agreement online and would prefer a paper copy, you can download the agreement from our web site or request them from our EDI Support Unit. Please return agreements by mail or fax forms to: ACS EDI Gateway, Inc.
ATTN: EDI Enrollment Unit
2324 Killearn Center Blvd.
Tallahassee, FL 32309
Fax: 850.385.1705 |
