All documents on this site require the free Adobe Acrobat Reader.

In addition to any of the following forms and documents, please download and read the following FAQ document. This document contains the most commonly asked questions we receive. Click here for the Questions and Answers Document.

Click here if you are having problems viewing PDF files on the Covansys website.

Enrollment Forms

Professional Confidentiality Statement Enrollment Checklist - Initial and Annual Requirements Enrollment Checklist - Second Annual and Ongoing Requirements for All Enrollees Professional Development Hours Form (EI and SC) Enrollment Application Criminal Background Check CFO Payee Agreement Service Coordination Parent Exception Certification Statement Practitioner Assurance Form Practitioner Supervision Documentation Rider A Rider B W-9 Entry Level Qualifications Birth to Three Direct Deposit Setup Birth to Three Direct Deposit Change Birth to Three Direct Deposit Cancel Birth To Three Core Knowledge and Competencies CKC Crosswalk Chart

Billing Information

WVBTT Billing Manual Services and Rates (PDF) Services and Rates (CSV) Application for Timely Filing Waiver

Electronic Billing Information

278 Authorization Response Companion Guide 835 Remittance Advice Companion Guide 837P Claims Transaction Companion Guide Trading Partner Agreement EDI Testing Procedures

How To Get a Free Email Account