Submit transaction enrollment requests

You can submit transaction enrollment requests either individually or in bulk through CSV import.

You must create one enrollment request for each combination of payer and transaction type. For example, you'd need two separate requests to enroll for 835 Electronic Remittance Advice (ERAs) and 270/271 eligibility checks with the same payer.

835 ERAs: Don't enroll until you're ready to switch to Stedi. Once you enroll, all ERAs from that payer will come through Stedi exclusively. You'll no longer receive ERAs from that payer through your previous clearinghouse.

Individual submission

Individual submission is the simplest way to complete transaction enrollment. It involves two steps: creating a provider record and submitting enrollment requests.

Step 1: Create a provider record

You must create a provider record with the name, tax ID, NPI, and contact information of the billing provider you plan to use in claims. Stedi submits this information to the payer as part of the enrollment process.

If you're a solo provider, this is likely your information. If you're enrolling a group practice, you only need to create provider records for the NPIs and the tax IDs you use for billing. You don't need to create provider records for individual rendering providers.

To create a provider record:

1. Go to the Providers page.
2. Click New provider.
3. Enter the required information:
   • Display name: A name to help you identify the provider record in your account. For example, "XYZ Medical Group". We don't share this name with payers.
   • NPI: The National Provider Identifier (NPI) on file with the payer that you use for billing. If you're enrolling a group practice, this is typically the group's NPI.
   • Tax ID: The tax ID, which can be an EIN or SSN. This should be the tax ID on file with the payer that you use for billing.
   • Contacts: This is where the payer will send communications about the enrollment, if needed. For many providers, Stedi can fetch contact information from the NPI registry. The name and address should exactly match what the payer has on file. However, the email and phone number can be set to wherever you want to receive payer communications.
4. Click Create provider.

The provider record is created and appears in the list on the Providers page.

Step 2: Create enrollment requests

Once you've created a provider record, you can attach it to one or more enrollment requests.

To create an enrollment request:

1. Go to the Enrollments page.
2. Click New enrollment.
3. Complete the required information:
   • Payer: Select the payer you want to enroll with. Start typing the payer's name to filter the list.
   • Provider: Select an existing provider record. The form automatically populates the provider's information. You can choose to use an existing contact or enter new contact information for the payer to use for communications about the enrollment. Review our guidance on provider contact information to ensure updates go to the correct location.
   • Transaction: Select the transaction type you want to enroll for. The form populates the list of transaction types that the payer supports, and you'll only be able to select transaction types that require enrollment.
   • Stedi contact person: This is the email address where Stedi will send updates about the enrollment request. We'll use it to notify you when there are next steps and send updates on the enrollment's status. This email address can be different from the contact information you provided in the provider record. Set it to wherever you want to receive Stedi's communications about the enrollment.
4. Click Create enrollment. Stedi asks you to confirm the information.
5. Review the enrollment information carefully and then click Submit enrollment.

The enrollment request is created and appears in the list of enrollments on the Enrollments page.

Bulk submission - CSV import

You can import enrollment requests from a CSV file. This is a great option if you need to submit many requests at once.

To submit enrollment requests through bulk CSV import:

1. Go to the Bulk imports page.
2. Click New bulk import. The upload page contains detailed instructions for formatting the CSV file and provides a template you can download.
3. Prepare your CSV file according to the provided instructions. We also recommend reviewing the instructions about contact information and practices and facilities with multiple providers or locations to ensure your file is set up correctly.
4. Click Upload CSV and select your file.
5. Click Verify file. Stedi checks for errors and flags any rows that require adjustments. If there are errors, you can either fix them and re-upload the CSV file or click Continue anyway to proceed with importing valid rows.
6. Click Execute import. Stedi processes the import and creates the enrollment requests.

You can review the status of each bulk import on the Bulk imports page. The overview shows the number of rows that were successfully imported, the number of rows that were skipped due to errors or duplicates, and the date and time of the import. Click an import to view more details and download the import status report.

Imported enrollment requests appear in the list of enrollments on the Enrollments page. When Stedi begins the enrollment process with the payer, we'll set the enrollment status to PROVISIONING and send you a notification email.

Importing behavior

Stedi automatically does the following when importing enrollment requests from a CSV file:

• Creates a new provider record for each unique combination of NPI and tax ID in the CSV file. For example, these two providers would be created as separate records even though they have the same name and NPI:
  • John Doe, NPI: 1999999984, Tax ID: 987654321
  • John Doe, NPI: 1999999984, Tax ID: 123456789

    When a row in your CSV file contains an NPI and tax ID that match an existing provider record in your account, Stedi overwrites the existing provider record with the information in the CSV file. Any changes (such as updated address or contact information) aren't automatically applied to existing enrollment requests for that provider, only to requests created after Stedi updated the record.

• Creates and submits enrollment requests.
• Removes duplicate rows to prevent duplicate requests.
• Skips rows that contain errors. For example, if a row contains an invalid NPI, Stedi skips that row and imports the rest of the file. Review the import status report to understand which rows were skipped and why.

Import status report

After importing, you can download a report that shows the status of each row in the CSV file. For example, duplicate rows are marked as Duplicate: Enrollment already exists in the result column.

To download the report:

1. Go to the Bulk imports page.
2. Click an import to view its details.
3. Click the ... (ellipses) and then select Download full report.

Rows with errors display a clear inline error message to help you make the necessary adjustments. You can fix rows with errors and re-upload the CSV file as many times as needed until all imports are successful.

Contact information

When you submit an enrollment request, you'll need to provide two types of contact information. It's important to understand the difference between them.

Provider contact

This is where the payer will send communications about the enrollment, if needed.

• The name and address should match exactly what the payer has on file for the provider. Some payers reject enrollment requests with addresses that don't match their records.
• However, you may want to set the phone number or email to a different contact - for example, a credentialing or general inbox - to ensure payer communications go to the right place.
• If you're enrolling a group practice, select a single administrative entity as the contact - don't use individual provider emails.

Where to add provider contact information

You can specify contacts on both the provider record and on the enrollment request.

• (Optional) Provider record: These contacts are for convenience - they allow the Stedi portal to prepopulate contact information options when you create enrollment requests. They aren't required when you create provider records, and they aren't automatically added to enrollment requests.
• (Required) Enrollment request: You must specify a provider contact on the enrollment request. This is the information that Stedi shares with the payer when submitting the enrollment on your behalf. This contact information doesn't need to match the existing contact information on the provider record, which allows you to use different contacts for different payers as needed.

Submitter email

This is the email address where Stedi will send updates about the enrollment. It's required when you submit an enrollment request - we use it to notify you when there are next steps and send updates on the enrollment's status.

This is called the Stedi contact person on the enrollment request form, and it's the user_email column in the CSV file for bulk imports.

This email address can be different from the contact information you provided in the provider record. Set it to wherever you want to receive Stedi's communications about the enrollment.

Complete enrollment tasks

Tasks are actions that either the provider or Stedi need to complete to move the enrollment process forward. Tasks can include:

• Providing additional documentation or signatures.
• Completing payer-specific requirements.
• Reviewing and confirming details.

When there's a new task that requires the provider to take action, Stedi adds a task to the enrollment request with instructions and sets the enrollment status to Provider Action Required. The email address listed as the Person for Stedi to contact will also receive a notification that there's a new task to complete.

You can review and manage tasks at the top of the enrollment request's details page in the Stedi portal. You must have the Operator role or above to complete enrollment tasks.

If the task requires you to complete and upload documentation, it will include instructions with a PDF template to download, fill out, and upload to Stedi.

Once you've taken the required action, check the box next to the task to mark it as complete.

Practices and facilities with multiple providers or locations

Some healthcare organizations operate multiple facilities or practices under a shared structure. This is common in hospital systems, clinic networks, or large medical groups where multiple service locations operate under the same billing entity.

Transaction enrollment requires the billing provider's tax ID and NPI that you plan to use in claims and Electronic Remittance Advice (ERAs). When the same group NPI and tax ID are used as the billing provider throughout the healthcare organization, you should:

• Create a single provider record with that NPI and the tax ID. You don't need to create provider records for individual rendering providers.
• Create enrollment requests with the billing provider record attached. You don't need to submit additional enrollment requests for individual rendering providers. Select a single administrative entity as the contact - don't include individual provider emails. This should be a credentialing or general inbox.
• Use the taxonomy code that matches the billing provider's credentials when submitting claims.

One-click enrollment

We offer one-click enrollment for eligible payers. Once you submit the enrollment request, Stedi handles the entire process without any additional action from you. These payers don't require any signatures or documentation other than what is included in the enrollment request.

To determine whether a payer is eligible for one-click enrollment:

1. Go to the Payer Network.
2. Search for the payer you want to enroll with.
3. Click the payer's name to view its details. Stedi lists the Type as One-click for transaction types that support one-click enrollment.

The following example shows that one-click enrollment is available for 835 ERAs with Blue Cross Blue Shield of Illinois.

Automatic enrollment requests

Some payers, such as the Centers for Medicare and Medicaid Services (CMS), require enrollment for eligibility checks.

Eligibility checks fail when a provider isn't properly enrolled. In these cases, Stedi automatically submits the required transaction enrollment request. Payers typically process these requests within 1-2 days.

We support automatic enrollment requests for the following payers in the Payer Network:

• The Centers for Medicare and Medicaid Services (CMS) (Payer ID: CMS)
• CMS MBI Lookup with SSN (Payer ID: MBILU)
• Highmark of Pennsylvania (Payer ID: 54771)
• Highmark Senior Health Company (Payer ID: 15460)
• Highmark Blue Cross Blue Shield of Delaware (Payer ID: 030)
• Highmark Blue Cross Blue Shield of West Virginia (Payer ID: 54828)

Please note:

• If the provider's NPI isn't active in the National Plan & Provider Enumeration System (NPPES), Stedi won't automatically create the enrollment for the NPI. The provider will need to apply directly with CMS to be added to the registry.
• For CMS enrollments, the provider must also complete attestation. Stedi adds a task to the enrollment request when attestation is required.
• For CMS enrollments, the transaction enrollment request will be rejected and set to REJECTED status if the provider's NPI isn't active in PECOS, the system CMS uses to manage active Medicare providers. In this case, we'll send you instructions explaining how to resolve the issue.

CMS attestation

The Centers for Medicare and Medicaid Services (CMS) requires providers to attest that clearinghouses are allowed to run Medicare eligibility checks on their behalf. This applies to all CMS trading partners, including Stedi.

Attestation is required for each billing National Provider Identifier (NPI) enrolled with CMS for eligibility checks. Stedi can't complete this step on the provider's behalf, and there is no bulk attestation across NPIs.

Therefore, Stedi adds a required attestation task to each CMS enrollment request for eligibility checks. The task contains instructions for the provider to complete attestation.

You can view the attestation task and its status in the Tasks section of the enrollment request's details page in the Stedi portal.

Attestation takes approximately 5-15 minutes to complete per NPI. Once complete, Stedi moves the enrollment to LIVE status. However, once attestation is complete, you can start submitting eligibility checks immediately, even if the enrollment status is not yet LIVE.