We provide the necessary paperwork (where additional forms are necessary) and assistance in completing the payer enrollment forms. We also do track and monitor the submitted forms and provide periodic updates regarding the status of your enrollments. We provide assistance in regeneration and refiling of agreement forms declined by the insurance.
The other reason forms generally get declined by the payer are when Providers or their staff are unaware of their billing setup with specific or certain payer(s) (such as the NPI, Tax ID, SSN, Legacy Provider ID/PTAN). For some payers, this information may be different from their usual billing info. Since, we rely on what is provided in the Practice Enrollment form to complete the payer agreement forms, any inaccurate information can cause delays or the form to be declined by the payer. All declined forms will have to be reworked and resubmitted. Please be on the lookout for any emails from us providing the status of the enrollment.
You will also be receiving email from our onboarding staff every 2 weeks on the status of all your enrollments – authorized, declined or in process payer enrollments. Any changes in enrollment status will also be notified immediately by the onboarding team. Please be on the lookout for emails from onboarding or support providing status of the enrollment.
Please feel free to contact our Onboarding team directly anytime for any questions or assistance to your enrollments by calling @ (510)284-2424 Option 2 or email – email@example.com.
If you are on the full edition of our software, you will have access to Enrollment Central to self-check the status of the enrollments. Preview of all submitted enrollment forms and their status can be viewed from this tool.
EDI enrollment or payer agreement is the process to setup the Provider for electronic claims or remits through our partnered clearinghouse. The Provider has to be registered and participating with the insurance to submit electronic claims or receive electronic remits.
If a form was declined, we may be able to regenerate the form for certain payers from the original submitted info. We will notify you if no action is required for such instances.
Please fix any rejects in the system and rebill the claims. It is imperative this process of running the status report and working the claims is followed diligently and if possible, daily to resolve any errors or claim issues and to prevent cash flow issues.
If you do not see any payer rejections for the claim and it shows Accepted or Acknowledged at the payer, you should receive an EoB (paper remit) or ERA (electronic remit) for the claim with either the payment info or a denial.