deseret mutual edi form for professional claims...edi instructions – deseret mutual – payer id...
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EDI Instructions – Deseret Mutual – Payer ID SX105 Page 2
Use these instructions for professional claim EDI enrollment for Deseret Mutual – Payer ID SX105
https://www.dmba.com/provider/EDIIntroduction.aspx
Trading Partner Number: HT005191-001 Electronic Transaction Types: checkmark Professional Claims (CMS 1500)
1. Select the link above 2. Select the “Begin the application for electronic billing” button
EDI Instructions – Deseret Mutual – Payer ID SX105 Page 3
3. Complete the online form with the provider information. However enter the Trading Partner noted above.
EDI Instructions – Deseret Mutual – Payer ID SX105 Page 4
4. PRINT A COPY FOR YOUR RECORDS 5. Select the “Submit Application Request”
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