EDI and ERA Enrollment with Apex Clearinghouse

EDI and ERA Enrollment with Apex Clearinghouse

ERA processing generally takes longer than claim enrollment. While typically ERA enrollment will complete (approve or reject) within 30-45 days, many insurance companies take a least 60 days to process. Be aware that industry changes can also delay this time frame. 

Not all payers require EDI enrollment.  For those payers that do not require EDI enrollment, you may begin submitting those claims through Apex immediately.  Once you have received EDI enrollment approval (for those payers that require it), you may begin submitting those claims through Apex.
ERA (Electronic Remittance Advice) enrollment timing also varies by payer.  Once the enrollment is completed on the payer side, they will begin sending your ERAs to Apex.  They will be displayed in your account under Electronic EOBs/ERAs as long has you have begun submitting claims in Apex EDI clearinghouse.  Once you begin receiving your ERAs, see our article on ERAs here:  Getting Started with ERAs

EDI and ERA Enrollment

My Clients Plus and Apex have teamed up to give you a seamless process to complete your enrollment forms for both EDI and ERA enrollments. 
  1. Log into your account in MCP 2.0 and go to Codes Setup > Insurance Companies
  2. Click on the "Apex Payer Enrollment" 
  3. Follow the instructions in the form.
  4. The last block of the enrollment form is for ERAs.  Enter the name of the payer and payer ID number, if you know it, for any payers you wish to receive ERAs from.
  5. Complete the required fields and Submit.

What happens next?

Once you have submitted the enrollment request to Apex EDI, Apex  will pull your enrollment requests together and send them to Madaket (a third party who is contracted with Apex to manage the enrollment process paperwork).  

It may take 1-10 days for Apex to process the enrollment request and send the enrollment to Madaket.  It may take Madaket 1-10 days to process the request in one of the methods below.

Depending on the requirements of the payer, Madaket may:

  • Send enrollments directly to the payer
  • Enrollments that require action from the provider such as Signatures, additional information or voided checks will be emailed to the contact person on the enrollment request
  • Send instructions on how to log into the online payer provider portal to update information.

 It is important to follow all these enrollment instructions carefully.

You can expect emails from Madaket within about 10 days if there is any follow-up required by the provider.

Payer response times can vary.  

  • Online EDI enrollment - this process is typically ready to go within a couple of days
  • EDI enrollment where forms are sent to the payers - these can vary from 2 - 6 weeks depending on the payer
  • ERA enrollments - these can be up to 60 days depending on the payer

Once the EDI (claims submissions) enrollment is approved, you will receive an email from My Clients Plus letting you know it is approved.  There are some cases where the payer may not respond to Madaket inquiries on enrollment status and the provider will need to follow up directly with the payer to see if the payer has processed their recent enrollment request.

With ERA (electronic remittance advice) enrollments, payers do not always let Madaket know when they are approved.  You should begin seeing ERAs in your My Clients Plus account when they begin flowing through Apex EDI clearinghouse.  

Approved EDI Enrollments

You will receive an email notification if your EDI Enrollment has been approved.  Questions regarding your enrollment status or enrollment paperwork, please contact Apex’s team of enrollment experts directly via email (mcpenrollment@apexedi.com) and they will get back to you within a few business days. Please include your NPI to expedite your inquiry.

Rejected EDI Enrollments

You will receive an email notification if any EDI enrollments were rejected.  Included in that email will be the cause of the error and instructions on how to make a correction.

To correct a rejected EDI Enrollment, go to Code Setup > Insurance Companies > Apex Payer Enrollment.

Click on Yes for having already completed the survey and then check the box fro Fix a Rejection.

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