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West Virginia Cover Letter - Please see the attached instructional document regarding enrolling for electronic claims submission.Electronic Claims Submission Form for West Virginia Submitters
- This form must be completed and returned to ACS by any provider, billing agent, and/or clearinghouse who wishes to submit electronic claims. Upon receipt of your completed form, ACS will acknowledge your enrollment in Electronic Data Interchange (EDI) by returning a Logon Information Sheet. The Logon Information Sheet will contain the information necessary for you to begin electronic filing.
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