Clearinghouse (US-only)
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      Integrated Clearinghouse Enrollment Process (US-only)

      In this article: 

      Overview of Enrollment Process

      Enrollment Process

      Step 1: Subscribe to Zanda Claims with Ensora Clearinghouse (formerly Apex EDI).

      • Go to the Settings > Practice >Subscription > Optional Add-Ons in Zanda.
      • Select Insurance Claiming and request Clearinghouse Enrollment
      • Agree to the terms and conditions.

      Step 2: Enroll with Ensora Clearinghouse (formerly Apex EDI).

      • Choose your enrollment type: Individual (Type 1 NPI), Group (Type 2 NPI), or Combination.

        • Type 1 NPI (Individual):

          • For healthcare providers who are individuals and sole proprietors. Eligible for only one NPI.

        • Type 2 NPI (Group):

          • For healthcare providers who are organizations, including physician groups, and corporations where an individual incorporates.
        • Combination Enrollment:
          • Credentialed with some payers as a Type 1 and some as a Type 2. Requires a combination enrollment.

      Step 3: Process your enrollments with Ensora Clearinghouse (formerly Apex EDI).

      • You’ll receive a welcome packet via email. Return it promptly.
      • Ensora Clearinghouse (formerly Apex EDI) Enrollment team will guide you through the remaining steps.

      Step 4: After Ensora Clearinghouse (formerly Apex EDI) enrollment approval.

      • A unique Ensora Clearinghouse (formerly Apex EDI) ID will be provided.

      Claiming Costs (Effective January 2025)

      • Enrollment Fee: $50.00

      • Per Claim: $0.15

      • Per ERA/EOB: $0.10

      • Per Eligibility Request: Free

      Requesting Ensora Clearinghouse (formerly Apex EDI) Clearinghouse Enrollment

      In this section of the article, we will guide you through the Ensora Clearinghouse (formerly Apex EDI) enrollment process. 

      1. You need to convert your Zanda account to be able to request the clearinghouse enrollment via the Zanda integration. 
      2. When you account is converted, go to the Settings > Practice > Subscription > Optional Add-Ons page,  to the 'Insurance Claiming' section.

      3. Carefully read the provided information and click the 'Request Clearinghouse Enrollment' button.

      4. Complete the enrollment information form, including your Business Name, Contact Email, Business Contact Phone and Billing Provider NPI Number, and click 'Next' to proceed. 

      5. Read the Zanda Integrated Insurance Claims Service Agreement, check the 'I have read and accepted the Service Agreement' box and click 'Submit'

      6. After the enrollment application is submitted, go to the Settings > Practice > Subscription > Optional Add-Ons page and continue to Ensora Clearinghouse (formerly Apex EDI) to enroll on their side.

      7. Once your enrollment is completed, we will send you a confirmation email. 

      8. On the Settings > Practice > Subscription > Optional Add-Ons page, you will see the status of your enrollment and your Ensora Clearinghouse (formerly Apex EDI) Vendor ID (it will consist of 3 characters). You can use this Vendor ID when you reach out for assistance to APEX support.  

      Ready for Claim Submission

      After the registration with Ensora Clearinghouse (formerly Apex EDI) is completed, you will be able to submit insurance claims. 

      1. When on a claim, there will be a "Submit Claim" button available for enrolled client
        Google chrome Workflow - Step 1 (29)

      Note:

      • Unless you are enrolled with Ensora Clearinghouse (formerly Apex EDI) via the Zanda integration, you will not be able to submit claims. 
      • Claims can only be submitted if the status is in 'Draft' or 'Failed' status. 
      • Lack of required information will prevent the claim from submitting.

      Current Claiming Functionality

      Currently, the Zanda in clearinghouse integration provides the following functionality:

      1. Linking invoices to claims for easier payment updates.
      2. Viewing the status of claims in Zanda.
      3. Printing claims as PDFs.
      4. After claim submission, Zanda will automatically handle status updates of claims daily, showing the claim status in the system.
        Alternatively, you will also be able to log into Ensora Clearinghouse (formerly Apex EDI) to view your payments and manage further details.

      5. The Claims report will include the following data columns:

      • Claim No
      • Date Created
      • Status
      • Client
      • Insurer
      • Practitioner
      • Amount
      • Invoices
      • Note
      • Actions

       

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      Zanda Claims FAQs:

      Do I need to enroll with Ensora Clearinghouse (formerly Apex EDI) for Zanda Claims?
      Yes, Ensora Clearinghouse (formerly Apex EDI) is the required clearinghouse.

      What is Ensora Clearinghouse (formerly Apex EDI) Enrollment?
      It notifies payers of your intent to submit electronic claims (EDIs) and receive ERA/EOBs through Ensora Clearinghouse (formerly Apex EDI).

      Already enrolled with a payer?
      You still need to enroll through Ensora Clearinghouse (formerly Apex EDI) for claims to be processed in Zanda. It is possible to use your existing Vendor ID, please email to support@zandahealth.com to request adding your existing Vendor ID to your Zanda account. 

      Enrollment duration:
      It can take up to 45 business days, depending on the payer.