Inmediata

Documents

PROTOCOLS

PROTOCOLS DESCRIPTION DOCUMENT
Medicare Part B
Puerto Rico Submitters
Medicare Part B
U.S. Virgin Island Submitters
Medicare Part A
EDI Enrollment Form (MA)
Medicare Part A VI
U.S. Virgin Island Submitters
CIGNA
Dental EFT Authorization
AETNA
AETNA ERA-835
HUMANA
ERA-835 (Hawaii, PR & VI)
SES-INMEDIATA
Providers & Hospital
CEDI-DME
CEDI Enrollment Agreement Instructions
MAPFRE
ACH-Electronic Payments
Delta Dental
Secure EDI ERA Enrollment
Molina Healthcare
Molina ERA Enrollment
RR Medicare
Agreement
Humana Medicare
Application process

FORMS

FORMS DESCRIPTION DOCUMENT
Installation Form
English
Formulario de Instalación
Español
Account Configuration Form
English
Formulario de configuración de la cuenta
Español
Accouting – Direct Debit Form
English
SecureEMR - Formulario para Cambios y Configuraciones
English

Chat support

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