Enrollment can be automatic but it can also be manual. Manual meaning that the Insurance Company (Payer) must approve the movement of Claims or ERAs to/from TheraNest. Below you will find a list of Payers that do require manual Enrollment.
If there is a green dot in the Enrollment Required column than EDI Enrollment is required. This means you will need to wait till you receive approval from them before you can start submitting Claims using Apex Clearinghouse.
IMPORTANT: The Apex Payer ID could be different that the Payer ID for your current Clearinghouse.
We advise that you do NOT hold on to claims while awaiting approval. The approval process can take up to 45 business days.
EDI and ERA are both types of communication.
- EDI is permission for the Customer/Provider to send the Claims electronically to the Insurance.
- ERA is permission for the Insurance to send the processing information back to the Customer/Provider.