Emdeon/Vision EDI Restoration Move to Optum iEDI

Before completing this Emdeon Vision setup form, please watch this short video for instructions:
Emdeon Vision Clients Restoration Video

Name
This field is for validation purposes and should be left unchanged.
Practice Name*
Practice Address*
Street Address City State / Province / Region ZIP / Postal Code
Compulink Account Number*
Optum Org ID*
To obtain this, log in to your Optum Portal. The ID should be listed in the top right of your portal screen.
NPI Numbers*
Please list all NPI numbers your practice currently uses to bill claims through Change Healthcare
Tax ID Number (TIN)*
Compulink Cloud User?*
Public IP Address*
Contact your Internet Service Provider to obtain this information, static IP is required. If you answered "Yes" for Cloud, enter "NA".
Technical Contact Name for EDI Restoration*
Technical Contact Email*
Technical Contact Phone*

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