Delaware Medicaid
Please follow the Enrollment Instructions below to become an electronic submitter for Delaware Medicaid.
Required Documents for those applying for new Submitter IDs
The following enrollment process is required and must be completed, signed and submitted to the Delaware Medicaid office prior to initiation of electronic claims submission or inquiry.
Please click the following link to begin their online Trading Partner Enrollment Process:
If the above link does not work properly please click this link to go to their Home Page:
Next click the link on the left for "Trading Partner Enrollment" then "Enrollment Application" on the following page.
If you have any questions regarding any of the options on their online portal, please call the Delaware Medicaid EDI Technology Support Center at 1-800-999-3371.
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
Electronic Claim Submission (ECS) Provider Agreement
Welcome
Please press "Continue" once done reading their welcome page
Profile Information
Please enter your Provider or Business name as the Trading Parnter Name
Please enter your address
For Type of Business enter Provider if you are billing on your own behalf or Billing Company if you are a billing service billing on behalf of the provider
Please enter enrollment and EDI contact information
Please press "Continue"
Transaction Sets
Please select "837I Health Care Claim: Institutional" if you send institutional claims (UB 04)
Please select "837P Health Care Claim: Professional" if you send professional claims (CMS 1500)
Please select "835 Health Care Claim Payment/Advice" if you wish to receive electronic remits
Press "Continue" once done
Electronic Signature Agreement
Click the box to "Accept"
Enter your Name in the box to electronically sign the document
Please press "Submit" to submit your application
Summary Page
Please print out this page for your records
Submitting your Forms
It is recommended that you keep a copy of the enrollment summary page for tracking purposes.
It is very important that you complete the entire process as described above. Incomplete applications will not be processed.
Waiting for a Response
Once the complete provider enrollment application has been submitted it will be processed. Processing will take approximately two weeks from the date of receipt.
After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If confirmation is not received after two weeks, contact the Technology Support Center toll-free at 1-800-999-3371.
Testing
Once you have received your Submitter ID and Password from Delaware Medicaid, please call the ClaimShuttle Support Team at 602-439-2525 and set an appointment for a Mailbox setup.