Apex: Combination Enrollment

  Permissions You must have Organization Administration Permissions.

An Apex Combination Enrollment means that you need to enroll in as both Type 1 and Type 2. There are various situations that might necessitate that, for example, your Practice is credentialed as a Type 2 NPI with a Payer(s), but your Individual Providers are credentialed as Type 1 NPI with another Payer. You would need to enroll as a Group (Type 2 NPI) and then the appropriate Providers as an Individual (Type 1 NPI).

If you are unsure how you a credentialed, check out this article.

Recommended Workflow: Enroll as Group (Type 2 NPI) and then Individual (Type 1 NPI).

Enroll with TheraNest Claims

This is a one time process, and it may have already been done. If not, before you enroll your Providers, be sure to Enroll with Claims and agree to the Terms & Conditions.

1. Click Billing tab in primary navigation bar.
2. Click Claims in side menu.
3. Click Request Electronic Claim Service and Agree to Terms and Conditions.

Type 2 NPI Apex Enrollment

1. Scroll down and select Group (Type 2NPI).
2. Select No if this is the first time you are filling out this Enrollment for FOR THIS PROVIDER.
   • Select Yes if you are filling out this Enrollment for again for a Provider who initially had an error. Learn more about failed enrollments.
3. Click Next.
4. Enter Contact Information and Billing Address for the primary contact for this enrollment and click Next.
   

   IMPORTANT: Fax Number is required. If you do not have one, you can enter your Business Number instead.

   • This contact will receive the confirmation email from Apex, enrollment status updates from TheraNest, will be contacted by a Change Healthcare Rep within 2 business days.
5. Enter Group (Billing) Practice Information. Click Next.
6. Select Claims Enrollment (also known as the EDI Enrollment Page).
   
   • Select the Payers you are currently credentialed for. These are Payers that require EDI Enrollment.
   • Select No if you're not credentialed with or do not currently submit to these Payers.
7. Select State where you Billing Location is located. Click Next.
8. Select Yes or No to indicate if you submit to any of the State Payers listed. Click Next.
   • If Yes, you will need to enter your PTAN Number for Medicare and your Provider ID Number for Medicaid.
9. Verify Electronic Remittance Advice (ERA) Enrollment screen.
   • ERA Enrollments will pull in all Payers that are currently listed in your TheraNest account under Billing > Insurers.
   • Remove any Payers listed that you do NOT want to receive ERAs from.
10. Click Submit. 

Type 1 NPI Apex Enrollment

You will need to repeat this process for each Rendering Provider credentialed as a Type 1 (NPI).

IMPORTANT:  If you do not follow the proper instructions below then you can expect an impact in the payment of your claims. 

1. Scroll down and select Individual (Type 1 NPI).
2. Select the Provider from dropdown.
3. Select No if this is the first time you are filling out this Enrollment for FOR THIS PROVIDER.
   • Select Yes if you are filling out this Enrollment for again for a Provider who initially had an error. Learn more about failed enrollments.
4. Click Next.
5. Enter Contact Information and Billing Address for the primary contact for this enrollment and click Next.
   

   IMPORTANT: Fax Number is required. If you do not have one, you can enter your Business Number instead.

   • This contact will receive the confirmation email from Apex, enrollment status updates from TheraNest, will be contacted by a Change Healthcare Rep within 2 business days.
6. Enter Practice (Billing) Information for the Rendering Provider. Click Next.
7. Select Claims Enrollment (also known as the EDI Enrollment Page).
   
   • Select the Payers you are currently credentialed for. These are Payers that require EDI Enrollment.
   • Select No if you're not credentialed with or do not currently submit to these Payers.
8. Select State where you Billing Location is located. Click Next.
9. Select Yes or No to indicate if you submit to any of the State Payers listed. Click Next.
   • If Yes, you will need to enter your PTAN Number for Medicare and your Provider ID Number for Medicaid.
10. Verify Electronic Remittance Advice (ERA) Enrollment screen.
    • ERA Enrollments will pull in all Payers that are currently listed in your TheraNest account under Billing > Insurers.
    • Remove any Payers listed that you do NOT want to receive ERAs from.
11. Click Submit. Repeat process for each Rendering Provider credentialed as Type 1.

Did My Enrollment Go Through?

After you submit your Apex Enrollment Survey you will receive two separate confirmations for each time you submit. 

1. Thank You screen - This screen lets you know that the form has been completed. No further action needs to be taken at this time. 
2. Confirmation Email - Within 24 hours you should receive a confirmation email for each completion of the enrollment survey. You can also wait 24 hours to contact TheraNest support if you did not receive an email to ensure it went through.  
   

   NOTE: You will receive a confirmation email for each Enrollment Survey you complete. This means you could receive several emails. Some emails may appear to be a duplicate, but they are not. If you have any questions, please reach out to TheraNest Support.