Washington Dental

Medicaid of Washington (DSHS)

  • Direct Link
  • Claims Processed through ACS EDI Gateway
  • Call (800) 833-2051 as early as 6 business days after form submission to check status of enrollment      
  • Both ACS forms below must be completed in order to set up electronically
  • Payer ID – WADCD

ACS Authorization Form

National Payers Requiring Enrollment


  • Direct Link
  • Payer ID – 89070 and 54771
  • If the office does not have a provider ID:
    • The office needs to call UCCI at (800) 633-5430, option 3, and let UCCI know that they will be submitting claims through Apex EDI.   Be sure to have them acknowledge every provider in the office that submits claims to UCCI.
  • If the office knows their provider ID you can submit the online form for them:
  • To Enroll for ERA’s:

Other National Payers Enrollment Forms