All providers, billing services and clearinghouses must enroll for electronic billing with Highmark Medicare Services.

Forms received from a provider using a billing service and/or clearinghouse will not be processed until their billing service and/or clearinghouse is enrolled.

Determine if you are a first time EDI customer, an existing EDI customer or a billing service or clearinghouse, and then complete the appropriate forms using the respective instructions below.

• If you are not currently an electronic biller and want to enroll to become an electronic biller, complete and return the "Electronic Data Interchange (EDI) Agreement Form" (Form 8275) and the "Electronic Data Interchange (EDI) Setup Requirements Form" (Form 8276). Please print these forms and the EDI Enrollment Instructions (Form 10202) from the list below.
  
• If you are currently an electronic biller and want to change your EDI enrollment status (e.g., to change software vendors, use or change a billing service or clearinghouse, etc.), complete and return the "Electronic Data Interchange (EDI) Setup Requirements Form" (Form 8276). Please print this form and the EDI Enrollment Instructions (Form 10202) from the list below. Note: the EDI Agreement Form (8275) is not required for existing electronic billers.
  
• If you are a billing service or clearinghouse and are not enrolled with Highmark Medicare Services, complete and return the "Electronic Data Interchange (EDI) Agreement Form" (Form 8275) and the "Electronic Data Interchange (EDI) Setup Requirements Form" (Form 8276) per the instructions given on the EDI Enrollment Instructions (Form 10202). Please print these forms from the list below.

Additional forms are needed if you would like to enroll for Electronic Remittance Advice (ERA) and/or the PC-ACE Pro32™ billing software. Click here to enroll for ERA. Click here to enroll for PC-ACE Pro32™.