Electronic Data Interchange Partner Enrollment

 
2
Medicaid Related Assistance
Medicaid & Long-Term Care
 
No
No

What would you like to do?

What you need to know

5010 Trading Partner Enrollment Forms             

All trading partners will be required to enroll and pass the testing process prior to exchanging 5010 transactions.

New Trading Partners:

Complete and mail the original, signed copy of the trading partner agreement to:

Department of Health and Human Services
ATTN: Medicaid EDI Help Desk
P.O. Box 95026
Lincoln, NE 68509-5026

The trading partner profile and trading partner authorization forms can be emailed or faxed after completion. Fax: (402) 742-2353; Email: DHHS.MedicaidEDI@nebraska.gov.

Current Trading Partners:

If you are an enrolled trading partner, but would like to add a new transaction, complete a new Nebraska Medicaid trading partner profile. Fax (402) 742-2353, Email or mail the completed form to the address listed above. Contact the EDI Help Desk to begin EDI Testing.

To begin or discontinue submitting transactions for a provider, complete a Nebraska Medicaid trading partner authorization.

Medicaid EDI Help Desk 
Department of Health & Human Services
Phone Number
(402) 471-9461
Toll Free Number
(866) 498-4357