Get the free The enrollment form for Florida Medicaid ERA is attached and has been modified so th...
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1755 Telstar Drive Ste 400 Colorado Springs CO 80920 www. optum.com FLMCD Thank you for choosing Electronic Network Systems Clearinghouse a division of Optum to submit your ERAs. Flmmis. com/account/manageagent. aspx Select Manage Agent Roles in order to link ENS to the account. This form is for Optum use only and will not be forwarded on to the payer with your Optum user ID Contact Name Group Name Group Billing TIN Group Legacy ID Taxonomy Code Please list all providers for this Payer below...
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