Enrollment is a process by which a provider informs a payer that they plan to interact with that payer electronically and submits provider demographic information to the payer in order to establish this electronic link.
Let's review the process for EDI and ERA enrollments with Avea.
Step by Step
During Implementation, you'll provide Avea or your Channel Partner a list of all Payers that you submit to.
- After go-live, Avea is notified when you've added a new electronic payer and we review these notifications regularly to initiate new enrollments for you.
- Avea adds the payer to your company's Enrollment Records Smartsheet and the record is updated throughout the rest of the process.
- Avea determines which enrollments each Payer offers and initiates the enrollment process for all. Some enrollments will be ready for immediate action, while others can take several business days for Clearinghouse to prepare.
- Avea completes all enrollments that require no action from the client.
- Avea sends you all enrollments that require action from the provider.
- The Provider signs and returns enrollment forms that require a provider's signature. Avea returns these to the Clearinghouse for forwarding to the payer.
- Provider completes any online registrations required by the payer, with assistance from Avea/Channel Partner whenever needed.
- Payers automatically start sending ERAs once enrollments are processed. Payers send paper EOBs in the meantime.
- Avea repeats the process as the client adds new payers to their AveaOffice account.
Tracking Enrollments with Avea
- We use a project management tool called Smartsheets to keep track of your enrollments and will send you notifications and requests for assistance with enrollments.
- New customers are trained on how to use Smartsheets during their Implementation.
What does Avea do for enrollments and what do I do?
|Provide instructions to you for 3rd party enrollments
|identify new eligible payers for enrollment after go-live
Initiate applicable electronic enrollments
Clearinghouse support (enrollments status, missing remits, general inquiries)
Registering with Payers
Registering 3rd Party Enrollment Vendors (Payspan, Zelis, Availity)
EFT (Electronic Funds Transfer)
Do you need help with enrollments?
Providers should contact email@example.com, or their point of contact at their Avea Channel Partner.