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400 Vermillion Street Hastings, MN 55033 Ph 8004823518 Fax 6513899152 www.edsedi.com DentaQuest DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION CX014 PAYER ID NUMBERS Electronic
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How to fill out era enrollment request paper
How to fill out era enrollment request paper
01
Gather all required information and documents needed for the enrollment request.
02
Fill in all the necessary details on the era enrollment request paper accurately.
03
Review the completed form for any errors or missing information.
04
Submit the filled out era enrollment request paper to the appropriate department or organization.
Who needs era enrollment request paper?
01
Healthcare providers who want to enroll in the Electronic Remittance Advice (ERA) program.
02
Organizations that handle billing and reimbursement for healthcare providers.
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What is era enrollment request paper?
The ERA enrollment request paper is a form that healthcare providers use to enroll in electronic remittance advice (ERA) services, facilitating the electronic receipt of payment information from payers.
Who is required to file era enrollment request paper?
Healthcare providers and practices that wish to receive electronic remittance advice from payers are required to file the ERA enrollment request paper.
How to fill out era enrollment request paper?
To fill out the ERA enrollment request paper, provide your practice's information, including tax identification numbers, contact details, and any specific payer information required. Follow the instructions provided by the payer for completion.
What is the purpose of era enrollment request paper?
The purpose of the ERA enrollment request paper is to ensure providers can receive electronic remittance notifications from payers, streamlining the payment processing and reconciliation workflow.
What information must be reported on era enrollment request paper?
The ERA enrollment request paper typically requires information such as practice name, address, tax identification number (TIN), National Provider Identifier (NPI), and contact person details.
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