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Forms Information about PDF Files


  • New Trading Partner Enrollment Form (Claims)- For a Provider office, Clinic or Hospital to apply for a new trading partner number and begin submitting claims (837) electronically to ASK.

To request status of an ERA Enrollment, send an email to

Change of Information
For existing electronic submitters (trading partners) who are changing software support vendors, formats or transactions, adding or removing NPI, or changing trading partner information other than contact name.

NOTE:  Change in Contact name – If it is necessary to add or change contact information the following options are available for reporting this to ASK.  You must include your trading partner number on these requests.

    • New contact information may be emailed to, if the email address contains the name of the organization.
    • New contact information may be faxed to ASK on company letterhead.  Faxes may be sent to 785-290-0720.

Secure Question Submission Form

* If you have questions, please contact us.

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