Setting Up Your Account

If you are an enrolled provider and have not received your PIN letter, please call our Web Portal ID/Password Help Desk at 1-800-289-7799, select option 5 to request a PIN letter.

To establish your secure Internet account, use your PIN and log on to the secure Web Portal, where you can access the Trade Files menu for submission and retrieval of EDI files.

Submitting claims: Direct Data Entry or Batch

With your secure Web Portal account, you can submit claims either through direct data entry or a batch file upload. With the direct data entry option you can submit one claim at a time. The batch file upload allows you to combine two or more properly formatted claims and submit them at one time.

Batch upload functionality is available on the secure Web Portal in the Trade Files menu.

File Upload
The File Upload page allows the user to select a file from a local hard drive and upload it to the Florida MMIS. Users of this feature include trading partners and providers that wish to upload batch EDI transactions, including claim and encounter submissions.

To use the Batch Upload option, providers must use HIPAA compliant software or vendors that can create required data in HIPAA compliant ANSI X12 Addenda format.

File Download
The File Download page allows the user to select a file from the secure Web Portal and download it to their system. The available files will be listed as hyperlinked file names. The download process begins when the link is clicked.

EDI testing process

• All trading partners, whether a provider, billing agent, or clearinghouse, must be enrolled as a provider in order to submit claims. An application must be submitted to EDS and will be processed by Provider Enrollment.
• In some cases, a provider may not have indicated a desire to submit electronic transactions when originally enrolled in the Medicaid Program. Enrolled providers that now wish to sign up for electronic billing must complete the EDI Agreement.
• Once the required documents are successfully completed, a letter will be mailed to the provider or trading partner. Included in the letter is trading partner information and directions for testing transactions using Ramp Manager.
• Ramp Manager is an online application provided by EDIFECS, which supports testing of X12 transactions against Florida Medicaid specifications. For more information on the testing process involving the Ramp Manager application please review the Ramp Manager Information Sheet.
• Companion Guides are available for specific Florida Medicaid requirements.
• If you are not currently accessing the Provider Secure Web Portal, a PIN letter is required to allow access to the secure Web Portal. The Provider Secure Web Portal will be utilized to upload files to and download files from EDS.
• The EDI Unit is available to answer any questions you might have about the EDI testing process.

Key Topics for EDI Submitters

SNIP Level Changes: The previous fiscal agent (ACS) processed all X12N data files using guidelines developed by the Strategic National Implementation Process (SNIP) levels 1 and 2. Levels 1 and 2 validate transactions for integrity/syntax and adherence to implementation guides. The current fiscal agent contract requires validation at levels 1 through 4. Level 3 and 4 validate transactions for balancing and situational elements in the HIPAA Implementation guide. The result is that some transactions that previously processed successfully may fail when validated against the higher SNIP levels. To assist in analyzing the impact to a submitter’s file, an interactive testing tool is available for all submitters. That testing tool is provided by EDIFECS and is called Ramp Manager. Please reference the SNIP Level Changes Information Sheet for more details on common SNIP level errors identified during test activities.

Claim level X12N Validation: EDS performs claim level X12N validation. Errors identified at the claim level will cause the rejection of the individual claim where the error occurred. This relates specifically to the processing of a claim batch before it reaches the Florida Medicaid Management Information System (FMMIS) for adjudication.

File Naming Convention: Details on the file naming convention by transaction type for outbound files sent from EDS are available in the File Naming Convention document.

Automated File Exchange: To support entities that desire a more automated interface for EDI file exchange, two options are available for consideration: Web Interface Script or Web Interface Source Code for large file uploads and downloads. If interested in this approach, please review the information on the Web Services for EDI Files Information Sheet and contact the EDI Service Unit for more information.

EDI File Merge Utility is an application that allows you to merge multiple compressed (or zipped) outbound X12 files created by EDS into one concatenated file. Please review the Merge Documentation for additional information.

To download the Merge Utility, click the following link:

Merge Utility Software