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Tools

EDI Download File Center

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.
Asynchronous Communications - Hyperterminal
EDI Agreement	The EDI Agreement is a required component of the entire enrollment packet for a provider submitting claims electronically, as stipulated by the Centers for Medicare and Medicaid Services.
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
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.
IVANS Medicare Access Solution TM Real-time Eligibility Software	Updates for the IVANS real-time eligibility software are conveniently located on a secure FTP site. Typically, maintenance updates are posted on a monthly basis. Please follow the instructions to access the site and download the latest software version.
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
Submitter Information Update Form
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