This form allows customers to request status on EDI Enrollment forms, Novitasphere Enrollment forms, and Part A Fiscal Intermediary Shared System (FISS Access) applications.
EDI Enrollment and Novitasphere Enrollment: Please allow 10 business days before inquiring on the status of these forms. Do not send duplicate forms. Once the form has been processed, a letter will be mailed if a new submitter was set up. Otherwise, a confirmation email will be sent to the contact person on the form upon completion of the form. All inaccurate or incomplete forms will be returned for correction.
Part A FISS Applications: Please allow 20 business days prior to requesting the status of an application. When a FISS application is processed, the requester will receive an email notification advising the user of their next steps. All inaccurate or incomplete applications will be returned for correction.
Additionally, the inquiry tool can be used to verify provider detail information, such as the correct Provider Transaction Access Number (PTAN), provider name, etc, prior to submitting a form to EDI.
Once submitted, an EDI Analyst will respond via email to your inquiry. If necessary, the EDI Analyst may reach out by telephone to discuss your inquiry.
Note:If questioning the status of an enrollment form submitted to link to a third party biller (billing service/clearinghouse), please include the name of the third party in the question block below.