Make Sure to Use Current Medicare Enrollment Forms

Providers should be sure to use current forms when enrolling in Medicare or updating enrollment information. 

The most recent EDI enrollment, vendor agreement, and PC-ACE agreement forms show a revision date of 03/10 in the lower left corner. Older forms are being rejected, and the requests will have to be resubmitted. 

Download current forms on the Highmark Medicare Services website.

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Last Updated: 6/17/2010
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