> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Enrolling for Claims Submission, ERA, and Real-Time Eligibility (EDI)

> Learn how to enroll for electronic claims, ERA, and eligibility with payers

This article provides step-by-step instructions on how to enroll for electronic claims submission, ERA, and real-time eligibility with payers in Elation Billing.

## Overview

### What is EDI Enrollment?

EDI (Electronic Data Interchange) enrollment is the process of setting up electronic connections with insurance payers for claims submission, Electronic Remittance Advice (ERA), and Real-Time Eligibility (RTE) checks. These are <u>three distinct services</u> that each require their own enrollment per Payer. You may need to complete enrollment for one, two, or all three depending on which services your practice uses. Each service has its own enrollment type and status indicator in the **Insurance** Settings payer list.

The enrollment type is specified by the Payer. The system routes you through the appropriate process as specified by that Payer. There are 3 possible enrollment types:

* Quick enrollment
* Paper enrollment
* Electronic enrollment

Enrollment should be configured based on how you are contracted with the Payer. If each entity has its own contract then you must enroll for services for each entity. If each Provider has their own contract then you must enroll for services for each Provider.

### Why is EDI Enrollment important?

Electronic enrollment enables faster claims processing, automatic payment posting through ERAs, and real-time eligibility verification—all of which improve billing efficiency and reduce manual work.

### Timing enrollments

Timing enrollments is important if you are coming from another billing software.

* Claims - This service can be available in multiple billing softwares. To minimize delays, enroll in this service as soon as you can, especially for Medicare.
* Eligibility - This service can be available in multiple billing softwares. To minimize delays, enroll in this service as soon as you can, especially for Medicare.
* ERA - This service can only be available in one billing software at a time.
  * For example, if you are currently receiving ERAs in your previous billing software and you don't want to switch to Elation until the start of the next month, then you should time your ERA service with Elation to start closer to the start of the next month. Refer to the [Checking enrollment statuses](https://help.elationhealth.com/#checking-enrollment-statuses) section below to learn how to determine the expected ERA enrollment timeline for a specific payer.

## Workflow Instructions

### Viewing your Payer List

<Steps>
  <Step>
    Ensure you have an **Admin** or **Manager** role to access these settings.
  </Step>

  <Step>
    Click **Settings** → **Practice Settings**.
  </Step>

  <Step>
    Click on the **Insurance** tab.
  </Step>
</Steps>

If you have [multiple practice entities](https://help.elationhealth.com/articles/practice-settings-setup-and-overview#practice-entities), use the **Entity** dropdown to select the one you want to view payer enrollments for.

<img src="https://mintcdn.com/elationhealth/CWM1OVXHaDp9DnEy/images/intercom/2715b65cb383_Elation_Billing_-_Entity_dropdown.png?fit=max&auto=format&n=CWM1OVXHaDp9DnEy&q=85&s=a0ef33c2fafa1ff7e21a7475bfb52f56" alt="Image" width="2656" height="1906" data-path="images/intercom/2715b65cb383_Elation_Billing_-_Entity_dropdown.png" />

***

### Identifying and favoriting Payers

Search for payers by name or payer ID. Click the heart icon to add them to your favorites list for easy access.

<Note>
  When searching for Medicare, Medicaid, or BCBS, search with the state prefix first (e.g., **CA Medicare**, **TX Medicaid**, **VA BCBS**).
</Note>

#### Adding a Payer

If you search for a payer that is not present, add them manually by following the steps below.

<Warning>
  Take caution when adding a Payer as they cannot be deleted.
</Warning>

<Steps>
  <Step>
    Click **+ Add Payer**.
  </Step>

  <Step>
    Use the [ClaimMD Payer List](https://www.claim.md/payer_list.html) to find official payer IDs and confirm supported electronic services.
  </Step>

  <Step>
    After adding the necessary info, select **Verify Address.**
  </Step>

  <Step>
    Click **Save**.
  </Step>
</Steps>

<Note>
  If a payer ID was entered incorrectly, create a new custom payer record with the correct ID.
</Note>

***

### Completing enrollments

When you click **Enroll**, the system routes you through the appropriate process as specified by that Payer. There are 3 possible enrollment types:

* Quick enrollment
* Paper enrollment
* Electronic enrollment

<Tip>
  You are completing YOUR portion of the enrollment. Payer processing times vary and you may not begin receiving the enrolled service right away.
</Tip>

#### Quick Enroll

You'll typically see this in the context of Eligibility enrollments.

<Steps>
  <Step>
    Click **Enroll.**
  </Step>

  <Step>
    Click **Start**. 
  </Step>

  <Step>
    If the payer allows for quick enrollment, then click the **Quick Enroll** button.

    <Frame>
      <img src="https://mintcdn.com/elationhealth/_WF8YQMpuRByusIR/images/intercom/e7f4082879c5_image.png?fit=max&auto=format&n=_WF8YQMpuRByusIR&q=85&s=8258dcf2fc0a1e64e7d6cd4c1fe29f95" alt="Image" width="1005" height="367" data-path="images/intercom/e7f4082879c5_image.png" />
    </Frame>
  </Step>

  <Step>
    Click **Mark Enrolled** in Elation Billing after clicking **Quick Enroll**.
  </Step>
</Steps>

#### Paper (Form) Enrollment

<Steps>
  <Step>
    Click **Enroll**.
  </Step>

  <Step>
    Click **Start**. 
  </Step>

  <Step>
    If a payer requires paper enrollment, then you see a pre-populated form (based on your Practice Entity details). Verify all of the details in the form are accurate.
  </Step>

  <Step>
    Click **Submit** **Document** to submit the pre-populated form to the payer.
  </Step>

  <Step>
    Click **Mark Enrolled** in Elation Billing after submitting the form.
  </Step>
</Steps>

<Note>
  If you did not submit the form or you exited out of the enrollment window before completing all required enrollment steps, click **No** instead of **Mark Enrolled**. This will indicate that there's a need to return to this enrollment at a later time.
</Note>

#### Electronic Enrollment

You'll typically see this in the context of Medicare enrollments.

<Steps>
  <Step>
    Click **Enroll**.
  </Step>

  <Step>
    Click **Start**.
  </Step>

  <Step>
    A new tab will appear with highlighted instructions (outlined in red) guiding you to another website where you can point the ERAs to our clearinghouse. Follow the exact instructions to complete the electronic enrollment steps.

    * Any details you require from Elation such as **Trading Partner ID** will be provided.
  </Step>

  <Step>
    Click the **Mark Completed** button at the bottom of the instructions (in the green box) once you complete the instructions to return to Elation Billing.

    <Note>
      If the **Mark Completed** button is present, it must be selected once the instructions have been followed. If not selected, ClaimMD will be unable to finalize your enrollment.
    </Note>
  </Step>

  <Step>
    Click **Mark Enrolled** in Elation Billing after completing the enrollment instructions in Step 3.

    <Note>
      If you did not complete all enrollment instructions or you exited out of the enrollment window before completing all required enrollment steps, click **No** instead of **Mark Enrolled**. This will indicate that there's a need to return to this enrollment at a later time.
    </Note>
  </Step>
</Steps>

***

### Checking enrollment statuses

Elation Billing does not show whether a service has been approved. To confirm a service's status, look for successful eligibility checks, try submitting an electronic claim, or check for an ERA in your ERA report. Alternatively you can ask the Payer directly for the status of the enrollment.

Claims and eligibility services are typically active within 2 Business Days of completing quick/electronic enrollment.

* Medicare's average time for Claim enrollment approval is 4 weeks.

Paper enrollments or ERA service enrollments can take the most time. You may see processing time information under the **Enroll** button (e.g. 14 Days) for certain services (e.g. ERA).

<Frame>
  <img src="https://mintcdn.com/elationhealth/axN6V524bgYhtISH/images/intercom/20d236ba4b1a_Enroll_14_Days.png?fit=max&auto=format&n=axN6V524bgYhtISH&q=85&s=536d5b63efda1700f3c8390cfdd516fe" alt="The ENROLL button - below it it says 14 Days" width="78" height="52" data-path="images/intercom/20d236ba4b1a_Enroll_14_Days.png" />
</Frame>

* If the typical processing time has passed with no updates, contact the payer directly to confirm enrollment status.

#### Enrollment Statuses

Use the **Insurance** Settings to check the status of each service in the payer list.

| Status     | Meaning                                                                                               |
| ---------- | ----------------------------------------------------------------------------------------------------- |
| Yes        | Service is automatically available - no enrollment required.                                          |
| No         | Service is not offered/available.                                                                     |
| Enroll     | Enrollment incomplete. Click **Enroll** to start the enrollment process.                              |
| Enrolled\* | Enrollment was marked complete.                                                                       |
| Custom     | The Payer was manually created by your practice. Complete enrollments under the original Payer entry. |

<Note>
  Keep in mind that "Enrolled" only reflects that the enrollment process was completed on your end. To find out if the payer has approved the enrollment, you must contact them directly.
</Note>

#### What should I do while I wait for enrollments to be approved?

* **Eligibility** - Check the patient's eligibility via external means (e.g. Payer Portal, calling the Payer, etc.)
* **Claims**
  * Leave the claims in Elation Billing until the Claims service is active for that Payer. (e.g. you can add a special Worklist tag like 'Waiting for enrollment' to the claim for easy identification).
  * Print paper claims and mail them to the Payer.
* **ERA** - Use your existing method of retrieving claims payment details (e.g. mail, Payer Portal, previous billing software, etc.) until ERA enrollment is active with Elation.

***

### Re-enrollment

<Warning>
  **Important Deadline:** All Medicare Real Time Eligibility (RTE) re-enrollments must be completed by **May 11th, 2026** to avoid service disruptions.

  **What's Happening**\
  The Centers for Medicare & Medicaid Services (CMS) has changed their processes around Medicare claim submission and is requiring all physicians and medical practices to re-enroll for Real Time Eligibility (RTE) verification. This change ensures that eligibility verifications can run smoothly and your Medicare claims can be paid in an efficient and timely manner.\
  \
  **Why This Matters**\
  If re-enrollment isn't complete by May 11th deadline, you will lose the ability to verify Medicare eligibility in real-time. This could result in:

  * Disruption to your practice workflow
  * Inability to verify patient coverage before appointments
  * Higher claim denials
  * Payment delays
</Warning>

Sometimes a payer may require you to re-enroll for a service after a period of time. To do so:

<Steps>
  <Step>
    Locate the payer + service that needs to be re-enrolled.
  </Step>

  <Step>
    Click on the green **Enrolled** button (or blue **Enroll**, if not marked as enrolled when previously completed)
  </Step>

  <Step>
    If the enrollment was previously completed, you will be routed to a page with Completion status details.

    1. In the lower left of this page, click **Re-Enroll** to reset the enrollment.

    <Note>
      Not all payers provide a self-serve re-enrollment option. If there is no **Re-Enroll** option, please open a support ticket with Elation so we can reset the enrollment on your behalf.
    </Note>
  </Step>
</Steps>

***

## Troubleshooting

### Enrollment not approved within the expected timeframe

Processing times vary by payer and enrollment type. If a payer displayed an estimated processing time (e.g., **14 Days**) and that window has passed with no status update:

<Steps>
  <Step>
    Contact the payer directly to confirm they received and are processing the enrollment request.
  </Step>

  <Step>
    If the payer confirms the enrollment was completed on their end but you're still not receiving the approved service, contact Elation Support.
  </Step>
</Steps>

### Enrollment was rejected

If the Payer tells you the enrollment was rejected, follow the instructions in the [Re-enrollment section](#re-enrollment) to submit enrollment again.

## Related Articles

* [Running Eligibility](/articles/running-eligibility)
* [Viewing ERAs and Auto-Posting](/articles/viewing-eras-and-auto-posting)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
