Create Enrollments Panel

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Enrollment Templates

Begin the Enrollment process by creating your Enrollment Templates.

• Enrollment Templates are used to auto-fill the Forms.
• If your Providers are all credentialed the same way with all Payers, you will only need to one Template.
• If your Provider is credentialed as an Individual with some Payers and as a Group with other Payers, you will need at least two Templates.
• Enrollment Templates can be created for a single Payer or multiple Payers.

• Single Payer: The Payer requires different criteria than other Insurances
• Multiple Payers: A generic Template can be created and used for multiple Insurances that require the same information.

Create Templates

• Select the Enrollment Templates link to create your Enrollment Templates.
• Select the Add button to create a new template.

• Copy an Existing Template or leave blank.
• Enter a Template Name.

• Complete the Credential Info, Practice Address Info, and Practice Contact Info Panels.

• If another Template was copied, the mandatory fields will auto-complete.
• If a Template was not copied, the info can be copied from the Libraries by selecting the Library from the dropdown.

***NOTE: If the Provider is credentialed as a Group, select Group for Entity Type. If credentialed as an Individual or is credentialed with the Provider's SSN, select Individual for the Entity Type. If credentialed with the SSN, enter the SSN in the Tax ID field.

• Using the checkboxes:

• Add Practice Contact to Enrollment Contacts.
• Add Practice Contact to Authorized Signer.

Common Payers Tab and Other Payers Tabs

Use the Common Payers and Other Payers tabs to locate the Payers to Enroll.

Common Payers Tab

• Payer Name
• State: Some Payers are state specific, such as Medicare and BCBS.

• The State colun will display the State when applicable.

• Payer ID: Shows the Payer ID needed for submitting Claims electronically.
• In Library:

• A green check mark indicates the Payers that already exist in your Insurance Library
• The Add link allows you to add the Payer to the Insurance Library on-the-fly.

• LOB: Line of Business (Professional, Institutional, Eligibility, or ERA)
• Action: Shows if an Enrollment is needed.

• Create Enrollment link is used for adding a single Enrollment.

• Existing Enrollments

Other Payers Tab

If the Payer is not on the Common Payers tab, look on the Other Payers tab. The Enrollment process works the same way.

Create Single Enrollments

***Medicare Claim Enrollment is required whether the Provider is PAR or NONPAR.

1. To Create a single Enrollment, select the Create Enrollment link.

2. Select your Template.

• When the template is chosen, it pre-populates the Template column.

• Edit the Template if necessary

3. Select Create Request and Download Packet [F2].

Create Multiple Enrollments in One Step

1. Select the check boxes for the Payers to complete Enrollments.
2. Select the Create Enrollments button.

3. Choose the Template to apply to all Payers selected.
4. Edit Template if necessary.
5. Select individual Templates if one or more require different Templates.
6. Select Create Request and Download Packet [F2].

Download/Upload Enrollments

Once an Enrollment is created and downloaded, it will be in the Downloads folder on your computer.

• The name of the downloaded file will be the Ticket number, Name of the Payer, and the Date it was downloaded.

• This information will be helpful to match the packet to the Enrollment located in the Waiting on Practice panel.

• Upload completed Enrollments using the Upload/Download option in the Action column.

• We are only able to accept one upload via the Enrollment tool when the ticket is in a status of Waiting on Practice.

• If you have additional documents to upload to EDI, such as a voided check for EFT setup, combine your documents into one before uploading so that you can send all documents needed by EDI in one upload.

• If you cannot combine the needed documents for an Enrollment, open a support ticket and attach the additional documents.

• Support will forward the attachments to EDI.

• The EDI team will review and submit the Enrollments to the applicable Payers.

Add a Payer to the Insurance Library

Use the Add link to add a Payer to the Insurance Library automatically.

• Selecting the Add link adds the Payer to the Insurance Library but does not display the Add/Modify Insurance screen.
• After selecting Add, a Popup icon will display in the Library column. If selected, it navigates to the Insurance Library where the Insurance can be modified.