PicturesAgingMedicaid Waiver InitiativePress ReleasesSearch NEBRASKA MEDICAID PROGRAM Page Content Medicaid Program Home Medicaid Services Medicaid Reform Medical Assistance Advisory Committee Current Initiatives Contacts Medicaid Electronic Health Record (EHR) Incentive Program Medical Necessity Guideline and Criteria Provider Information Program Integrity CHIP Managed Care Pharmacy Services Rules and Regulations Medicaid State Plan Electronic Data Interchange Client Information Recent Web Updates Nebraska Medicaid Program Electronic Data Interchange (EDI) 5010 Trading Partner Enrollment Forms EDI Enrollment Forms Version Published Nebraska Medicaid Trading Partner Agreement 3.0 01/07/15 Nebraska Medicaid Trading Partner Authorization MS-85 MS-85 06/23/14 Nebraska Medicaid Trading Partner ERA/835 Authorization MS-86 MS-86 06/23/14 Nebraska Medicaid Trading Partner ERA/835 Authorization MS-86 Instructions 06/14 06/24/14 Nebraska Medicaid Trading Partner Profile 3.0 03/09/15 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 ServicesATTN: Medicaid EDI Help DeskP.O. Box 95026Lincoln, 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 866-498-4357 (toll free) or 471-9461 (in Lincoln) Email: DHHS.MedicaidEDI@nebraska.gov Documents in PDF format require the use of Adobe Acrobat Reader which can be downloaded for free from Adobe Systems, Inc.