Electronic enrollment with insurance payers allows you to submit claims and receive electronic remittance advice (ERA) through Carepatron. This article outlines how to set up electronic enrollments using our clearinghouse partner, Claim.MD.
📋 What is an Enrollment?
An enrollment is the process of notifying an insurance payer that you intend to:
Submit electronic claims
Receive electronic payment reports (ERAs)
Note: Some payers require enrollment only for ERAs, not for claim submission or eligibility checks.
✅ Prerequisites
Before starting enrollment, make sure the following are complete:
1. You're credentialed with the payer.
Ensure you've already been registered and credentialed with the payer outside Carepatron. Enrollments cannot be processed until you have completed the payer's credentialing process.
2. Import Claim.MD Payers
Carepatron uses Claim.MD as our clearinghouse. Payers must be imported from Claim.MD into your workspace.
3. Set Up Billing Profiles
Each practitioner or group must have a Billing Profile in Carepatron that includes:
National Provider Identifier (NPI)
Tax Identification Number (EIN or SSN)
These details are required to match your enrollment information with the payer’s records.
📝 Enrolling for Electronic Claim Filing
To submit claims electronically:
Go to Settings > Insurance
Locate the correct payer and click View
Under the Claim filing section, find your billing profile and click Enroll
Complete the Claim.MD enrollment form
The status will show as Processing while it's reviewed
Once accepted, the status will change to Active – you're ready to file claims!
💵 Enrolling for Electronic Payment Reports (ERAs)
To receive ERA files:
Go to Settings > Insurance
Click View for your chosen payer
Under the Payment reports (ERA) section, click Enroll beside the correct billing profile
Complete the Claim.MD enrollment form
Status will show as Processing
When accepted, the status changes to Active
📡 Enrolling for Eligibility Checks
Electronic eligibility checks are not yet supported in Carepatron. However, you may still complete any required enrollments with the payer in advance.
🛠️ Troubleshooting Enrollments
If an enrollment is rejected, Carepatron will notify you with the rejection reason.
You can resubmit the form anytime after fixing the issue.
If your billing profile is missing an NPI or Tax number, it will appear as Incomplete and can't be enrolled.
In some cases, Claim.MD or the payer may not return enrollment status updates. If this happens and you're blocked from claim submission, contact Support.
Claims can still be submitted while an enrollment is processing.
If you're part of multiple workspaces, enrollments will apply to all workspaces that use the same NPI and Tax number.
Our team will be able to answer any other questions you may have. Just reply via messenger through the Help channel in your workspace.