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Clearinghouse Payer Enrollments

How to get setup for electronic claim submission, ERA's and insurance verifications?

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Written by Rachel
Updated over a week ago

Electronic claims processing can eliminate the paper and streamline the process of submitting your insurance claims and receiving payments. With NikoHealth, you'll save time and get paid faster from insurance companies so that you can avoid costly delays and disruptions to cash flow.

Clearinghouse Enrollment

The clearinghouse acts a gateway to facilitate the transmission of electronic claims between insurance carriers and providers.

Different payers support different types of electronic claims functionality. This may include:

  • Electronic claim submission

  • Electronic remittance advice (ERA)

  • Insurance eligibility verification

To start, you must enroll with each individual insurance carrier (payer) you plan on conducting transactions with. Don't worry, our payer enrollment team works on any required enrollments on your behalf.

Once you add the payers, please notify our team to begin the enrollment process by sending an email to payerenrollment@nikohealth.com.

Please note some payer enrollments may require authorized signatures, online portal registration, or approval follow-up directly by the provider. In the event any steps need to be taken a NikoHealth payer enrollment team member will be in contact via email.

It is important to note that if your company is currently using a clearinghouse for electronic transactions:

  • Claim submissions and insurance eligibility can be run simultaneously out of multiple software systems

  • ERAs, on the other hand, can only be remitted to a single software system. This means that once approved by the payer all ERA's regardless of which system the initial claims were submitted from will come into NIkoHealth

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