Trading Partner Sequence name - Name of your agency.
Trading Partner Sequence number - When EDS sent back the original TPA (years ago) it was on that piece of paper.
If you don't have this, call Provider Solutions and give them your provider numbers, and they can find the sequence number for you.
Mailbox/Login/Submitter ID - login ID (you can find this in Barnestorm by going to Codes > Program Related Codes > Payer Codes, click the Electronic Claims Setup tab, and find the SenderID item. This is the mailbox # to fill in on the form.)
Appendix A
Check Professional Claim; Institutional Claim; Health Care Payment and Remittance Advice; Health Claim Status; Eligibility for a health plan.
Signing for EDI Partner - you sign and print here.
(older version only) Appendix B: Check Secure FTP Communication
Get correct TPA version here:
http://www.ncdhhs.gov/dma/hipaa/