Enrollments
You can begin sending transactions to many payers immediately. However, there is a subset of payers that require enrollment before they will accept transactions, such as claims and eligibility checks, and before they will send you claim payments (ERAs). Enrollment involves submitting information about the provider that will send or receive transactions, including the provider’s name, tax ID, NPI, billing address, and contact information.
You can find out if a payer requires enrollment for a particular transaction type in the Stedi Payer Network.
Enrollment process
You submit an enrollment request to the Stedi customer success team, and we’ll handle the entire enrollment process for you, including submitting the required information to the payer and monitoring the status of the enrollment.
You can either manually submit enrollment requests through the Enrollments page or submit bulk enrollment requests using the Enrollments API.
Both submission methods follow the same process:
Add a new provider record.
The provider record includes the information required to enroll the provider with payers, including the provider’s name, tax ID, NPI, and contact information.
Submit an enrollment request.
You submit enrollment requests to enroll the provider with required payers. An enrollment request includes the provider record, the transaction type you want to enroll, the payer you want to enroll with, and a designated contact that the payer can communicate with about the enrollment. You must create one enrollment request for each transaction type. For example, you would create three separate requests to enroll a provider for 837P claims (professional), 270 real-time eligibility checks, and 835 ERAs (claim payments).
You can create enrollment requests in DRAFT status. When you’re ready to submit them to Stedi, you can change the status to SUBMITTED. Once you submit the enrollment request, you can no longer update it without contacting support.
Stedi submits the enrollment to the payer.
Stedi begins the enrollment process with the payer and sets the enrollment status to PROVISIONING. Some payers have additional requirements, so Stedi will contact you if needed to move the process forward. In addition to updating your enrollment request with action items required for your team, we’ll also reach out to you in your dedicated Slack channel with resources and to answer any follow-up questions.
Once the enrollment is approved, the enrollment status is set to LIVE, and the provider can start exchanging the enrolled transactions with the payer.
Review enrollment status
You can review the details and status of every enrollment request on the Enrollments page in Stedi. Alternatively, you can use the List Enrollments endpoint.
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