Integrations
Provider enrollment
Before a payer accepts electronic claims from your clinic, or sends you electronic remittance, your practice and its clinicians must be enrolled with that payer. ArkCloud does not do this enrollment and does not track it. This page lists what you do outside ArkCloud and what you then record in it.
Written for: Practice owners and administrators · Billing leads · Implementation teams
Status
Payer (provider) enrollmentNot available
ArkCloud does not enroll your practice or clinicians with payers, for claims, ERA or EFT, and does not track enrollment applications. Your practice does this with each payer and your clearinghouse.
Payer enrollment can take several weeks. Start it early: until it is done, claims are built and checked in ArkCloud but cannot be sent.
What your practice does outside ArkCloud
- Open an account with a clearinghouse that offers an SFTP mailbox, and ask it which payers need enrollment for electronic claims (837), remittance (835) and claim status.
- Enroll the practice (billing provider) and, where the payer requires it, each rendering clinician with each payer, using the clearinghouse's or the payer's own enrollment process.
- Enroll separately for ERA and, if you want it, electronic funds transfer (EFT). These are usually separate forms from claim enrollment.
- Keep the approval letters and the effective dates for your records.
What you record in ArkCloud
Once a payer has enrolled you, make sure ArkCloud holds the identifiers claims are built from.
| Field or control | What it means |
|---|---|
| Payer record | The payer, its claim filing indicator and any identifiers your clearinghouse needs. See Payers. A payer record connects nothing by itself. |
| Facility | The billing provider's NPI, tax ID and taxonomy code that appear on claims. See Facilities. |
| Clinician billing | Each rendering clinician's NPI, in ArkCloud Rehab under Settings → Clinician billing. A claim line whose clinician has no NPI is refused before it is sent. |
| Clearinghouse mailbox | Entered once for the whole service by ArkCloud, not by your organisation. See Clearinghouse setup. |
The Enrollment (834) screen is about patients, not providers
| Capability | Status | What that means here |
|---|---|---|
| Member enrollment files (834) into coverage proposals | Partially available | Staff can upload an 834 benefit enrollment file today; each coverage change becomes a proposal that a person approves or rejects, and nothing changes a patient's coverage until it is approved. Receiving 834 files automatically needs the clearinghouse mailbox.Requires: The clearinghouse mailbox, for automatic receipt only. |
ArkCloud RCM has a screen called Enrollment. It handles 834 benefit enrollment files, which a health plan or employer sends to say which members (patients) are covered. It has nothing to do with enrolling your practice with a payer.
ArkCloud RCM → RCM Dashboard → Enrollment (834)
- Upload an 834 file, or let it arrive through the clearinghouse mailbox once that is connected.
- Each coverage change appears as a proposal. Where the patient match is uncertain, confirm it by choosing the patient.
- Approve to apply the change to the patient's coverage, or reject it. Nothing changes until someone approves.