Medicare Enrollment
Answered
I have received an approval letter through Medicare that I am able to file claims electronically. When I called to check the status of my enrollment to submit through your clearinghouse, Medicare said it had been approved. Why does it still say "submitted" and not "ready to file claims"?
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Hi Sheri! I'd be happy to help with this question. Sometimes, insurance payers will notify you (the provider) that your enrollment has been accepted without notifying our clearinghouse. All you need to do is reach out to our Success team with a copy of the approval letter so we can notify our clearinghouse and get your enrollment accepted on our end. I've created a request to our Success team on your behalf, so keep an eye on your inbox for an email from our team. Let me know if you have any questions or would like additional assistance with this - we're here to help.
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I also recently received an approval letter from Medicare indicating the need to complete an EDI enrollment. When I proceeded with the process on their website (EDISS Connect, via Noridian) it asks for "vendor name or trading partner ID (TPID)" and there's a drop down menu to search...but SimplePractice isn't on the list. Does SP have a TPID I can enter?
Thank you,
Lisa Hardebeck/Olympic Psychology Services
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Hi Lisa, I'd be happy to help with this.
In that case, it sounds like the approval letter was for credentialing with Medicare. You'll want to submit an enrollment through SimplePractice to Medicare now, and you'll receive an enrollment document with instructions as well as clearinghouse information that you can use to complete the process on EDISS.
I've reached out to you via email for next steps for this payer in particular, and we can continue this conversation there.
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Same questions for me. I have been approved by Medicare. I have my PTAN. My EFT authorization agreement has been processed and approved. Now I am stuck. My practice uses SP but not for billing (I am only a contract employee). I am responsible for my own Medicare billing and would prefer to go through SP. I attempted the EDI and messed that up...now it won't let me make edits or sign the form in order to submit. Definitely need help. Wondering if I need to hire a billing consultant to walk me through the process. Any help would be much appreciated!!!
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"In that case, it sounds like the approval letter was for credentialing with Medicare. You'll want to submit an enrollment through SimplePractice to Medicare now, and you'll receive an enrollment document with instructions as well as clearinghouse information that you can use to complete the process on EDISS."
Hi there, I am currently in the same boat. Would you please send me the same instructions/application?
Thank you!
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Hi Ashley, I'd be happy to help with this. To get started on your enrollment with Medicare, you can follow the instructions in this guide from our Help Center: How do I submit an enrollment to file claims or receive payment reports?
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I am filling out an EDI enrollment application for Medicare to be connected to Simple Practice. The information I was previously given for the clearinghouse is:
Eligible, Inc., 1842 Union Street, San Francisco, CA 94123-4308. (888) 909-3055, contact: Kelly Rose Gleason.
Is this information still correct. When the application asks for the address, number, name etc. for the "vendor" are they referring to the clearinghouse.
The application also asks for the "entity" name, number, address, contact person, the contact person's title and email. Is Simple Practice the "entity". What is the name, number, address etc.?
Thank you for your assistance.
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Hi Jodie,
I understand that you have some questions regarding how to complete the EDI enrollment application for Medicare, and I've provided my responses below:
1. Is the clearinghouse's information which I provided still correct?
Yes, this information is correct.
2. When the application asks for the address, number, name etc. for the "vendor" are they referring to the clearinghouse.
Yes, our clearinghouse will be considered the Vendor.
3. The application also asks for the "entity" name, number, address, contact person, the contact person's title and email. Is Simple Practice the "entity". What is the name, number, address etc.?
To make sure we're on the same page, can you provide me with the screenshot of the section in question? I can pass this information along to our clearinghouse for review.
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Hi Justine, we'd be happy to help. Here's a guide on enrolling for claim filing in SimplePractice so you can start filing claims: https://support.simplepractice.com/hc/en-us/articles/207925273-How-do-I-submit-an-enrollment-to-file-claims-or-receive-payment-reports-
I'd also recommend taking our Getting Started with Insurance Billing class at simplepractice.com/classes.
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Hi Gillian, thank you for link, however, I've searched through the list of payers and there's no option to select Medicare for California. The closest is one entry that says "Medicare for CA HI and NV". However, there's no link to enroll or assign this payer to the client. There are just dashes in the payer ID, electronic and paper enrollment columns. And I went through your guide again and did not see how it can resolve my issue.
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Hi Justine, I'd be happy to help. Medi-Cal is often billed through third-party agencies. Here's another post on our Community Forum where Ryan, a CAMFT chapter leader, shares some additional information on billing Medi-Cal. https://support.simplepractice.com/hc/en-us/community/posts/360055285531-Medi-Cal-and-Mental-Health-Network
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Hi Gillian, I don't need to be bill Medi-Cal. I need to bill for Medicare. I only mention Medicare for California specifically because Noridian was assigned to handle our Medicare Application/paneling since I'm in California at not New York or some other jurisdiction.
Bottom line, how do I enroll to bill for Medicare? Is there a clearinghouse or insurance payer on your list that I have to assign to my client so that I can start billing? Or is there an enrollment process I have to complete first?
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I too am trying to add Noridian Healthcare Solutions to your payer list. The payer ID I recieved for them is 01182. I'm in jurisdiction E (Southern California ) and not D. Can you please contact me directly with the steps that you have offered other individuals on this thread.
thanks
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I just received my Medicare EDI enrollment approval. I was advised to wait 3 days before submitted a test file to Medicare. How can I do that, and do I need to submit the Medicare approval letter to Simple Practice for the magic to happen? Your response is greatly appreciated. Thank you!!
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