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O. Box 8128 1717 West Broadway Madison WI 53713 WPS Medicare EDI 608 223-3824 Fax Phone 800 782-2680 Email edi wpsic.com Phone 866 503-9670 Email Medicare part A edimedicarea wpsic.com For further updates visit our website at http //www. 1755 Telstar Drive Ste 400 Colorado Springs CO 80920 www. optum.com IAMCR Thank you for choosing Electronic Network Systems Clearinghouse a division of Optum to submit your Claims/ERAs. DEG3 Provider Contract Information Required. DEG4 Provider Agent...
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What is the era enrollment form?
The era enrollment form is a document used to enroll in the Electronic Records Access system.
Who is required to file the era enrollment form?
Any individual or entity who wishes to access electronic records is required to file the era enrollment form.
How to fill out the era enrollment form?
The era enrollment form can be filled out online by providing the necessary personal and contact information.
What is the purpose of the era enrollment form?
The purpose of the era enrollment form is to grant access to electronic records for authorized users.
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The era enrollment form requires information such as name, address, contact information, and reason for requesting access.
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