If you enrolled your Payers before 5/1/21, your Enrollments will be processed with Madaket. You will complete the process with Madaket, but any new Enrollments going forward will be completed with Change Healthcare.
What is Madaket?
Apex has partnered with Madaket to help process Enrollments. This is great news for you! Not only does Madaket help to fill out the Enrollment Forms, and manage the Enrollment process, they have also formed partnerships with Insurance Companies that allow us to process your Enrollments more quickly!
In this process, if an Insurance Company requires additional Enrollment Forms, you will receive emails from Madaket with EDI and ERA Enrollment Forms attached to complete and submit.
Madaket will send you emails if the Payer you are enrolling requires additional information. Fill out all information required and send them back to Madaket or the address indicated. Below are some FAQs to help you fill out the Madaket forms.
- Why am I getting so many emails from Madaket?
There are a couple of reasons you may be receiving emails from Madaket:
There are some Insurance Companies that request you complete additional forms in order to send Claims or receive ERAs with them. If you are enrolling with a Payer that requires these additional forms, Madaket will send them.
You may also be receiving a number of forms because your Enrollment indicated that you will bill both Type 2 (Group) and Type 1 (Individual) NPI. To ensure your Enrollment would go through, we submitted both requests. If you know how you are credentialed with these Payers, you will just need to sign and complete the forms with the correct NPI.
- In reviewing the documents, there are fields that are empty that I'm not sure how to fill out.
Apex Clearinghouse will be able to best help you with specific Payer questions. Email them at TNEnrollment@apexedi.com
- I have questions on how to complete an application. Should I contact you or Madaket?
We always want you to contact TheraNest Support first!
- I received EFT Forms, can I ignore these?
NO! Some Insurance Companies do require that you are enrolled with EFTs in order to get ERAs from them.
IMPORTANT: Even if you are already setup with EFTs, you will STILL need to complete this section or your Insurance Company will reject your Enrollment.
- Where do I send the forms that direct me to "send to the Administrator or Admin"?
Send them to the fax number, email address, or physical address that is on the cover letter of the enrollment forms.
- Do Office Ally ERA Transfer Letters need to be printed on Company letterhead?
Yes, they do!
- What if an Enrollment website link is not working?
Sometimes Insurance Companies will take pages down for scheduled maintenance. If a link is not working, simply try again later. If you are still not able to get in after a day or two, contact TNEnrollment@apexedi.com
Why do my Apex Enrollment Forms say Office Ally, Change Healthcare, or Optum?Although you will be submitting EDI Claim and receiving ERA payment details through Apex, some of the EDI and ERA enrollment forms may come with Office Ally, Change Healthcare, or Optum verbiage.
This is because some Insurance Companies have agreements to only send EDI/ERAs through a certain Clearinghouse. In order to ensure that Claims are sent with these Insurance Companies through Apex, Apex will sometimes work with 3rd Parties like Office Ally, Change Healthcare, and Optum in order to transmit Claim information.
There is no additional charge for these 3rd Party Enrollments. You will still work directly within TheraNest to submit claims, check claim status, and receive ERA payment details.
- I don't know my PTAN Number - How do I find it?
You can your PTAN Number on your Medicare Welcome Letter you received when you were credentialed. If you can't locate that letter, call your Medicate Provider Representative and they will be able to assist you.
- I don't know a Provider ID the Enrollment is asking for.
You can typically find your Provider IDs on the Welcome Letter you received from that Insurance Company. If you can't find that letter, or it's not listed there, call the Insurance Company and they will be able to assist you.