Enrollment

To receive a Trading Partner ID and logon information, please complete and return the ACS EDI Gateway Enrollment Packet for Wyoming Medicaid.

Important Enrollment Information (PLEASE READ):

• Provider EDI Authorization Form for Billing Agents /Clearinghouses: ACS EDI Gateway will no longer accept billing agent/clearinghouse client list.  We have supplied a Provider EDI Authorization Form that must be completed by the provider authorizing the Billing Agent or Clearinghouse to submit transactions and/or retrieve responses on their behalf. 
   
• ACS EDI Gateway, Inc. has two types of agreements: 1) Trading Partner Agreement (TPA); 2) Trading Partner/Business Associate Agreement.  These agreements are executed between the provider/submitter and ACS EDI Gateway, Inc. as the covered entity.
  A provider/submitter should execute these agreements based on the following guidelines:
   
• Execute the Trading Partner Agreement (TPA) if you are a provider/submitter sending and/or receiving standard format.
   
• Execute the Trading Partner/Business Associate Agreement (TP/BAA) if you are a provider/submitter sending and/or receiving a non-standard format that must be converted to a standard format.
   
• Note:  ACS EDI Gateway prefers that submitters execute these agreements online.  However, if they are unable to access the agreements online and would prefer a paper copy, agreements can be downloaded from our GCRO web site or request them from our EDI Support Unit.

• EDI Submitter Enrollment Form Instructions
• EDI Submitter Enrollment Form
• EDI Trading Partner Agreement (PDF)
• EDI Trading Partner/Business Associate Agreement (PDF)

EDI Provider Enrollment Packet for X12N Transactions:  This packet consists of the following documents:

• EDI Provider Enrollment Form Instructions
• EDI Provider Enrollment Form
• EDI Trading Partner Agreement (PDF)
• EDI Trading Partner/Business Associate Agreement (PDF)

You may direct inquiries to the ACS EDI Support Unit, Monday through Friday, 8 a.m. - 5 p.m. MST, at 800.672.4959.