Transcription of Printing Instructions - eMedNY
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Printing Instructions - eMedNY
Printing Instructions It is important to use the following Printing Instructions so that the submitted form processes accurately. Select Print Button from upper left hand corner of screen . In the print box under Page Scaling, change the defaulted option from Shrink to Printable Area' to None' as shown: eMedNY -401001 (06/08). PROVIDER. ELECTRONIC/PAPER TRANSMITTER IDENTIFICATION NUMBER (ETIN). APPLICATION. This ETIN application form is to be used only by enrolled providers. It is not to be used by service bureaus or billing agencies submitting transactions (claims) on behalf of an enrolled NYS Medicaid provider. Service Bureaus/Billing Agencies must complete a Service Bureau/Billing Agency ETIN Application, located at To apply for an Electronic/Paper Transmitter Identification Number (ETIN), which is required to send and receive New York State Medicaid data electronically or on paper, please complete the items below and forward, along with a Certification Statement to: eMedNY .
Printing Instructions It is important to use the following printing instructions so that the submitted form processes accurately. Select Print Button from upper left hand corner of screen. In the print box under Page Scaling, change the defaulted option from ‘Shrink to Printable Area’ to ‘None’ as shown: EMEDNY-401001 \(06/08\)
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