Jump to Section:
What is EDI & ERA Enrollment?
EDI is permission for the Provider to send the Claims electronically to the Insurance Payer, and ERA (Electronic Remittance Advice) is permission for the Insurance Payer to send details about how Claims were paid or denied, to the Provider. An ERA is an electronic version of the explanation of benefits (EOB).
- EDI: Provider --> Claim ---> Insurance
- ERA: Insurance --> EOB --> Provider
Some Payers, but not all, require EDI Enrollment before you can submit Claims to them electronically.
EDI & ERA Enrollment Tips:
- Only enroll for EDI Enrollment for those Payers that you are contracted with.
- Not all Payers require EDI Enrollment.
- If you do not currently receive ERAs, you are not required by the system to enroll for them, however, some payer may require ERAs as part of their EDI Enrollment.
Enroll Payers in EDI & ERA
- Click Important tile on your system homepage.
- Click Go to Pre-Enrollment button.
- Complete the Ensora Clearinghouse EDI Enrollment Survey.
Complete Enrollments
Once you have submitted the Enrollment Survey to Ensora Clearinghouse, they will complete your enrollment request.
- The Ensora Enrollment team will contact you within 2 business days of Enrollment to gather any additional information needed for you EDI/ERA Enrollment - e.g. Tax ID, Billing NPI, Payers, etc.
- The Ensora Enrollment team will then submit your enrollment forms to your Payers.
- IF a Payer requires the Provider or Agency to directly submit enrollment via a portal, The Ensora Enrollment team will walk you through the process.
- The Ensora Enrollment team will serve as a consistent contact point through the process and will provide weekly Enrollment Status updates.
- Contact the Ensora Enrollment team for any questions regarding your EDI/ERA Enrollments.
- The Ensora Enrollment team will work with you and the Payer to resolve Enrollment rejections.
Click here >> Step 2: Add Electronic Billing Subscription
Once your Payers have been enrolled AND Approved (not just submitted), you will add one of the 3 Ensora Clearinghouse Electronic Billing Subscriptions to your subscription. You can select your desired subscription level, process up to 50 Claims per month, 300 Claims per month, or unlimited Claims per month.