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EDI CHANGE OF SUBMITTER FORM (for use by currently enrolled providers only) Check all lines of business that apply: Part A J5 Part B J5 Part A J8 Part B J8 J5 National Part A Group/Provider NPI Number

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What is edi change of submitter?

The EDI change of submitter is a form used to update the submitter information for Electronic Data Interchange (EDI) transactions.

Who is required to file edi change of submitter?

Any organization or individual who is the submitter for EDI transactions is required to file an EDI change of submitter.

How to fill out edi change of submitter?

The EDI change of submitter form can usually be filled out online or by submitting a paper form with the updated information.

What is the purpose of edi change of submitter?

The purpose of the EDI change of submitter is to ensure that accurate and up-to-date information is used for EDI transactions.

What information must be reported on edi change of submitter?

The information required on an EDI change of submitter form typically includes the submitter's name, contact information, and any changes to the submitter's organizational structure.

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