EDI Instructions – Deseret Mutual – Payer ID SX105 Page 2

Use these instructions for professional claim EDI enrollment for Deseret Mutual – Payer ID SX105

https://www.dmba.com/provider/EDIIntroduction.aspx

Trading Partner Number: HT005191-001 Electronic Transaction Types: checkmark Professional Claims (CMS 1500)

1. Select the link above 2. Select the “Begin the application for electronic billing” button

EDI Instructions – Deseret Mutual – Payer ID SX105 Page 3

3. Complete the online form with the provider information. However enter the Trading Partner noted above.

EDI Instructions – Deseret Mutual – Payer ID SX105 Page 4

4. PRINT A COPY FOR YOUR RECORDS 5. Select the “Submit Application Request”