Payer Template and Reconciliation

Version D.0

• Commercial COB Scenario 1 Payer Sheet
• Commercial COB Scenario 2 Payer Sheet
• Medicare Part D Payer Sheet
• How to contact PDMI to set up testing

Version 5.1

• PDMI Payer Sheet
• How to contact PDMI to set up testing

5010

• 835 X12 Description 5010
• Test X12 835 Document
• X12 835 Request for Production Form
• How to contact PDMI to set up testing

4010

• PDMI X12 835 Payer Template
• Test X12 835 Document
• X12 835 Request for Production Form
• How to contact PDMI to set up testing