If you're already submitting claims through TheraNest using a different clearinghouse or if you've already requested Insurance Claim Service and wish to switch to Apex EDI please know Apex Enrollment will be available to you soon.
TheraNest users with Organization Administrative permissions will be able to enroll with Assisted Claims with TheraNest using our Clearinghouse parter Apex EDI.
Before You Enroll
Know that enrollment is a process. Once you complete your enrollment survey in TheraNest you may not be done or able to submit claims right away. Find out here what payers require manual enrollment.
Please be sure that you've prepared properly to enroll. This will save you lots of time and work for the future. Please click here to read over some requirements.
Also, we recommend you add your payers to TheraNest before enrollment. Follow the steps in this article to add your payers to TheraNest.
- Go to Organization > Claims Service
- Click to Request Electronic Claim Service and Agree Terms and Conditions. You will receive a green confirmation bubble and your page will refresh.
- Choose NPI Type 2
- Have you already completed this survey? If this your first time filling out the enrollment survey select "no." If your filling out this form again mark Yes and then mark your reason. Click Next.
- Complete Contact Information and Billing and Address information. This will be the main contact person in regard to enrollment. You will receive confirmation email from Apex EDI, if applicable additional email with forms from Madaket, and enrollment status updates from TheraNest. Fax Number is required but you can put your business number in there if you do not have a fax number.
- Mark the box of who the checks from the insurance companies go to. This should default to Type 2 since you chose Type 2 above. No need to change anything here. Click Next.
- Complete Group Practice information. Click next.
- Individual Providers: Will default to the person completing the form. Make sure Tax ID and Individual NPI is correct.
- Mark the box if you have additional providers in your office.
- If you mark Yes, all providers with a 10 digit NPI will pull in the box. To remove any providers simply highlight and delete. If you do not see a provider listed make sure they have a 10 digit NPI entered in on their Staff Details profile. Click next.
- If you mark No, simply click next.
10. You will then be taken to the Claims Enrollment page or also known as the EDI enrollment page. From here you will mark the box for the payers you are currently credentialed for on this page. These are the payers that REQUIRE EDI enrollment. If you're not credentialed with or do not currently submit to these payers then DO NOT MARK THE BOX YES.
11. You will also be asked to select which state your billing location is located. If you have multiple states you will need to complete the enrollment form for each state. You will then be taken to your State Payer page. On this page mark yes for the state payers you currently submit to. If Yes: You will need your PTAN number for Medicare and your Provider ID number for Medicaid. Click Next.
12. ERA Enrollment will pull in all payers that are listed in your TheraNest account under Insurers. Remove any payers listed in the ERA box that you do not wish to receive ERAs from. Please know for each payer listed here it's possible you will receive an email from Madaket with additional steps.
13. Click Submit