Even if you are already credentialed with a payer, additional enrollment paperwork may need to be submitted in order to submit electronic claims to the payer via TherapyNotes. Accurately completing this paperwork ensures that your claims will be processed quickly and will help you avoid unnecessary claim rejections.
Prior to completing enrollments, ensure that the information you have entered in TherapyNotes exactly matches the information your payers have on file.
Enroll to Submit Electronic Claims
Most payers do not require enrollment in order to be able to submit claims electronically. For those that do require enrollment, instructions will be provided once you initiate the enrollment process.
To determine if you must enroll for electronic claim submission with a payer:
- Click Payers > Payer Name > Info tab
- Locate the section labeled Clearinghouse Services
- The symbol that is shown next to Claims indicates the enrollment status for the payer.
A green check indicates that you are ready to submit electronic claims to this payer. This occurs if the payer does not require enrollment paperwork or if you have already completed the enrollment paperwork for this payer.
A yellow caution sign indicates that further action is required to submit electronic claim to this payer.
To begin enrollment to submit electronic claims for a payer
- If the payer is new to your practice and requires enrollment, first Save the payer to make the Begin Electronic Claims Enrollment button available
- Click on the Begin Electronic Claims Enrollment button
On click of the Begin Electronic Claims Enrollment button, you will be directed to a new tab containing the enrollment instructions for this payer. Follow all the instructions provided on this tab. It is important to note the enrollment process may differ significantly between payers.
The following are common enrollment instructions you may be provided:
- Auto-Enroll: The new tab simply states "Auto-Enroll". This means your enrollment request is on its way and there is nothing else for you to do to submit an enrollment request for this payer.
- Online Form: The new tab displays an online form specific to the payer and prepopulated with information available from your TherapyNotes account. Complete all required fields highlighted in red, noting that some may start as optional and become required as you answer questions on the form. Additional form instructions may be provided, including requests to attach documents - please read all provided information carefully. Once completed, submit the document using the “Submit Document” button within the window.
3. Further Enrollment Instructions: The new tab will display a list of Enrollment Instructions for you to complete on the payer’s website. Please follow these steps carefully. In some cases, the Enrollment Instructions may be informational only. Be sure to return to this page once all steps provided are finished to click the “Mark Completed” button.
After enrollment has been initiated, the enrollment button will change to read 'Check Enrollment Status.'
Use the ‘Check Enrollment Status’ button to access pending enrollment instructions again, view status information about a completed enrollment request, or to re-enroll if necessary.
Electronic Claims Enrollment Approval Process
Enrollment approval is often not immediate, so we suggest not submitting claims until you receive enrollment acknowledgement from the payer which may take up to 5 business days. Sending claims prior to receiving enrollment confirmation from the payer will result in claim rejections.
For any questions about the status of a submitted enrollment request, please contact the payer directly.
Tips for Completing the Electronic Claims Enrollment Process
- One of the most common reasons for rejected enrollments is a Tax ID or NPI mismatch. Make sure that the information used for enrollment exactly matches the information that your payers have on file.
- Double check your work to ensure the documents are filled out completely. These forms are not created by TherapyNotes, they are made by the payers. Required fields may not be immediately visible and can result in rejected enrollments.
- For some payers, enrollment for electronic claims will also cover enrollment for ERAs. If this is the case, you will be notified in the enrollment instructions and only need to submit a single enrollment request for the payer.
When in doubt, contact our support team at (215) 658-4550, option 4. This will connect you directly to our enrollments specialists who will be able to help you with any questions you may have. Please do not contact CLAIM.MD directly for enrollment support. They are not able to assist and will direct you back to our TherapyNotes support team.
Payers that Do Not Support Electronic Claims
CLAIM.MD handles electronic claims to over 2,800 payers nationwide. However, if a payer does not have a known payer ID in TherapyNotes, our clearinghouse is unable to send claims electronically to the payer. For these payers, you can generate a CMS-1500, Superbill or a paper claim.
To generate a paper claim:
- Leave the Payer ID field blank
- Confirm the mailing address for the insurance is provided
- Update the Billing Method to Electronic Claims
Claims for this payer will appear alongside other claims on the Submit Electronic Claims page for you to review and submit.