Enrollment Hub
Manage payer enrollments, ERA/EFT setup, and transaction agreements
1
Active Enrollments
2
Pending Review
0
Rejected / Needs Action
3
Total Enrollments
Your Enrollments
ENR-001Blue Cross Blue Shield
837P / 835·Electronic Remittance + Claims·Route: Claim.MD
Submitted: 2024-11-15
Effective: 2024-12-01
Rep: Maria Santos
Required Documents
W-9
ERA Authorization
EFT Form
ENR-002Aetna
270/271·Eligibility & Benefits·Route: Claim.MD
Submitted: 2025-01-02
Rep: Derek Owens
Required Documents
Enrollment Form
NPI Registry Printout
ENR-006Medicaid
837P·Claims Submission·Route: Claim.MD
Submitted: 2025-01-08
Rep: Derek Owens
Required Documents
State Medicaid Enrollment Form
Provider Agreement
New Enrollment
Medicaid 837P Enrollment
✓
Select Payer✓
Choose Transactions✓
Provider Information4
Upload Documents5
Review & SubmitUpload Documents
State Medicaid Enrollment Form
Provider Agreement
W-9
Available Payers
Medicaid
77002
UnitedHealthcare
87726
Humana
61101