Resources for Completing Enrollments

Use the following resources to complete the Enrollment Process:

• The Coversheet provides Payer-specific instructions.
• Enrollment Templates are pre-populated with the Payer-specific Enrollment data when possible.
• Select the Plus icon in the Messages column to communicate directly with the EDI team.
• Ensure that the entire Enrollment packet is uploaded after completion.
• Claims are critical for Go Live.
• If you are unsure that an Enrollment is needed for a Payer, see the Enrollments panel on the Insurance Dashboard.

Before Starting the Enrollment Process

• Review the Enrollment Check List for information you will need to complete the Enrollments.
• Complete the Pay To/Billing Location Library and the Billing/Rendering Providers Library setups for the Providers that will be authorized to sign the Enrollment documents.
• Add any necessary Payers to the Insurance Library.

Start the Enrollment Process

• On the Home Dashboard, select the Enrollments button.
• Admin Users can easily manage and track the Enrollment process.

Enrollments Dashboard

• The Title Bar shows your Go-Live Date.

• For Help with Enrollments:

• Select Show Me How on the banner for guided help with the Enrollment process
• For Questions regarding an existing Enrollment or a Payer's Enrollment form, contact our EDI team.

• Select the Plus icon in the Message column to enter a note to communicate with the EDI team.
• For further questions for existing Enrollments/Payer Enrollment forms, call 330-341-0568, Option 1.

• For help using the Enrollment Dashboard, review the Help content in Show me How.

• If you have further questions regarding the Dashboard, contact our Support Team.

Filter Criteria

If the correct Filter Criteria was entered but no results were returned, the Payer likely does not need an Enrollment. See the Enrollments panel on the Insurance Dashboard to verify. The default Filter Criteria ONLY shows Payers that require an Enrollment. To see Payers that do not require an Enrollment, adjust the Filter Criteria.

Use the Filter Criteria to narrow your search.

• Status: Search by the Status that the Enrollment is in.
• Tax ID & NPI: If your Practice has more than one Tax ID or NPI, using this Filter makes it easier to segregate them.
• State: The State can be used to Search for Medicare, BCBS, & Medicaid Payers since they are State specific.
• Practice: This is particularly helpful for Billing Companies.
• Line of Business: Search by Institutional, Professional, Eligibility, ERA, Dental, or Status Request.
• Ticket: Because each Enrollment is assigned a Ticket number, it can be used in the Search criteria.
• Payer Name: The Payer name can be searched.

• Use a partial part of the name.
• For example: Search for all of the Great West Payers on the Other Payers Tab.

• Entering Great West produces 2 Payers: Cigna Great West and Great West Healthcare.
• Entering Great West Healthcare only produces 1 Payer: Great West Healthcare.

• Payer ID: Some Payers have more than one Payer ID, which may result in not pulling all relevant Payers.

• For Example: Cigna and Cigna Great West:

• Cigna Great West: Payer ID 80705R
• Cigna: Payer ID 62308

• Created From/Created To: Use the date that the Enrollment was created.
• Enrollment Required: Use this filter to display only the Payers that require an Enrollment vs those that do not.
• Unread Messages: Include/Exclude unread messages or pull only the Messages that have not been read.
• Insurance in Library: Include/Exclude Payers that are in the Library or only Payers that are in the Library.

• Using this filter can make it easier to spot those Payers that you use which are not in the Insurance Library.

• Jopari: This filter only applies to clients who use Jopari. You can easily pull only the Jopari Payers.

Panels on the Enrollments Dashboard

The number in brackets on each panel represents how many are in each Status.

• Create Enrollments
• Waiting on Practice
• Waiting on Clearinghouse
• Waiting on Payer
• Closed

Insurance Dashboard Enrollment Panel

There is an Enrollment panel on the Insurance Dashboard which displays the Enrollments for the Payer.

• Enrollments can also be created here by selecting the link in the Action column.​

Upload/Download Enrollments

The Upload/Download Enrollments option is on the Waiting on Practice panel in the Action column.

For help with the Enrollment Process:

• Select the Plus icon in the Message column to communicate directly with the EDI team.

• For further questions, call 330-341-0568, Option 1.
  

Learn More

• Create Enrollments Panel
• Waiting on Practice Panel
• Download Enrollments
• Upload Enrollments
• Waiting on Clearinghouse
• Waiting on Payer
• Closed