How to Download a PDF Trading Partner Enrollment Package

You can enroll as trading partner by mail after downloading a trading partner enrollment package online. You must have Adobe Acrobat Reader software installed in order to view and print the document.

Optionally, you can:

• Download enrollment instructions.
• Download enrollment FAQs.

To download a trading partner enrollment package

1. Do one of the following:

   • On the Provider menu, click Enrollment.
   • On the Quick Links pod on the public Home page, click Provider Enrollment

   The Provider Enrollment page is displayed.

2. In the Become a Trading Provider panel, click Download a PDF Trading Provider Enrollment Package.

   Note: You must have Adobe Acrobat Reader software installed in order to view and print the documents.

3. Print the document.

4. Complete the documents, being sure to include all required information.

   Tip: An * (asterisk) indicates required fields.

5. Mail the trading partner enrollment package and any other necessary documentation to the address provided.

See Also

Version as of 6/30/2015.