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EDI Help Desk West Virginia Medicaid PO Box 625 Charleston WV 25302-3932 edihelpdesk unisys.com 304 348 3380 Fax Unisys March 8, 2004, Dear Trading Partner: Attached is an Electronic Trading Partner
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How to fill out clearinghouse trading partner agreement:

01
Gather all necessary information and documents required for the agreement, such as legal business name, contact information, and tax identification number.
02
Review the agreement thoroughly to understand the terms, conditions, and obligations of being a trading partner with the clearinghouse.
03
Fill in the required sections of the agreement, including but not limited to company information, authorized representative details, and agreement duration.
04
Provide any additional information or attachments requested in the agreement, such as proof of insurance or financial statements.
05
Make sure to accurately complete all sections and double-check for any errors or omissions before submitting the agreement.
06
Submit the filled-out agreement to the appropriate contact or department within the clearinghouse, following their specific submission instructions.

Who needs clearinghouse trading partner agreement:

01
Healthcare providers who want to exchange electronic healthcare transactions and data with the clearinghouse.
02
Health plans, including insurance companies and managed care organizations, who need to transmit and receive electronic data through the clearinghouse.
03
Other entities within the healthcare industry, such as pharmacies or laboratories, who require electronic transaction capabilities and collaboration with the clearinghouse for seamless data exchange.
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The clearinghouse trading partner agreement is a legal document that establishes the terms and conditions for trading partners to participate in a clearinghouse. It outlines the rights, responsibilities, and obligations of each party involved in the trading relationship.
Any entity or individual intending to participate as a trading partner in a clearinghouse is required to file a clearinghouse trading partner agreement. This includes both buyers and sellers who wish to engage in trading activities through the clearinghouse.
To fill out a clearinghouse trading partner agreement, you will need to provide specific information about your business, such as your name, contact details, business registration details, and any additional information requested by the clearinghouse. The agreement may also require you to provide details of your trading preferences, financial information, and any applicable certifications or licenses.
The purpose of a clearinghouse trading partner agreement is to establish the rules and procedures for trading partners to engage in trading activities through a clearinghouse. It ensures that all parties involved understand their rights and obligations, sets out the terms of trade, and provides a framework for dispute resolution and the enforcement of contractual obligations.
The specific information required to be reported on a clearinghouse trading partner agreement may vary depending on the clearinghouse and the nature of the trading activities. However, typical information that may be required includes the legal name and contact information of the trading partner, details of the business or entity, financial information, trading preferences, and any applicable certifications or licenses.
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West_Virginia VIRGINIA Unisys EDI CFR HHS HIPAA WV 2004 TPA nonstandard GLB unenforceable viii omissions proscribed VII edihelpdeskunisys 1320d-2 seq costeffective transmittal XIX XIV unenforceability XVII timeliness preempts wvdhhr SEVERABILITY XVI XV

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