To receive a Trading Partner ID and logon information, please complete and return the ACS EDI Gateway enrollment packet for Maryland PMHS.

All submitters are required to complete the Maryland PMHS EDI Trading Partner Enrollment Form.

Enrollment Packet: The enrollment packet consists of two documents, which includes the EDI Enrollment Letter and Maryland PMHS Trading Partner Enrollment Form.  To download these forms, please click on the document link below.

• EDI Provider Enrollment
• EDI Provider Enrollment Instructions
• EDI Submitter Enrollment
• EDI Submitter Enrollment Instructions
• Maryland PMHS Trading Partner Agreement

This document may be faxed to 850.385.1705 or mailed to the address below.

ACS Enrollment Department
P.O. Box 14600
Tallahassee, FL  32317- 4600

 If you have any questions regarding the ACS EDI Gateway Enrollment Packet, please call ACS EDI Gateway Support Unit at 1.800.830.9024, Monday through Friday, 8:00 a.m. to 5:00 p.m. EST.

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