In this article:
- Overview of Enrollment Process
- Requesting APEX Clearinghouse Enrollment
- Ready for Claim Submission
- Current Claiming Functionality
- Zanda Claims FAQs
Overview of Enrollment Process
Enrollment Process
Step 1: Subscribe to Zanda Claims with Apex.
- 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 Apex.
- Choose your enrollment type: Individual (Type 1 NPI), Group (Type 2 NPI), or Combination.
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Type 1 NPI (Individual):
- For healthcare providers who are individuals and sole proprietors. Eligible for only one NPI.
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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.
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Step 3: Process your enrollments with Apex.
- You’ll receive a welcome packet via email. Return it promptly.
- Apex Enrollment team will guide you through the remaining steps.
Step 4: After Apex enrollment approval.
- A unique Apex ID will be provided.
Requesting APEX Clearinghouse Enrollment
In this section of the article, we will guide you through the APEX enrollment process.
- You need to convert your Zanda account to be able to request the clearinghouse enrollment via the Zanda integration.
- When you account is converted, go to the Settings > Practice > Subscription > Optional Add-Ons page, to the 'Insurance Claiming' section.
- 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 Apex 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 APEX 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 APEX is completed, you will be able to submit insurance claims.
- When on a claim, there will be a "Submit Claim" button available for enrolled client
Note:
- Unless you are enrolled with APEX 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:
- Linking invoices to claims for easier payment updates.
- Viewing the status of claims in Zanda.
- Printing claims as PDFs.
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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 Apex 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
Zanda Claims FAQs:
Do I need to enroll with Apex for Zanda Claims?
Yes, Apex is the required clearinghouse.
What is Apex Enrollment?
It notifies payers of your intent to submit electronic claims (EDIs) and receive ERAs through Apex.
Already enrolled with a payer?
You still need to enroll through Apex 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.