Please follow the Enrollment Instructions below to become an electronic submitter for Kansas Medicaid.
Required Documents for those applying for new Submitter IDs
The following documents are required enrollment documents that must be completed, signed and returned to the Kansas Medicaid office prior to initiation of electronic claims submission or inquiry.
1. Kansas MMIS Electronic Data Interchange Application
If the above link does not work properly, please download the form from:
Choose EDI at the top then select EDI Application
If you have any questions regarding any of the documents in this package, please call the EDS EDI Technology Support Center at 1-800-933-6593 option 4.
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.
Select Provider and enter your Medicaid PIN number
Enter your Business/Practice or Provider Name
Complete your demographic information
Enter the name of the main contact person for your office and his/her contact number.
Enter your e-mail address
Please mark “Other” and please enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our billing software please call our support line for our software information.
Select “Internet File Transfer”
In this section you may choose the following:
837 Professional (CMS 1500 billing)
837 Institutional (UB04 billing)
Please complete this section.
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
DXC Tehcnology EDI Department
P O Box 3571 Topeka, KS 66601-3571
It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Technology Support Center toll-free at 1-800-933-6593 option 4.
Once you have received your Submitter ID and Password from EDS, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to EDS.
Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.