Payer Enrollments

Time to Complete	1-3 hours
Skills Required	No technical skills!

To use 1-Click Health, your company must be a healthcare provider with one or more NPIs (National Provider Identifiers). Verified uses your NPIs — and the input user data you provide — to source user health insurance data from payers. We’re able to source this data from most payers immediately, but some payers require additional enrollment steps to be completed before they start returning data.

We handle as much of the payer enrollment process as possible, to save your team time and effort. We can complete enrollments with many payers on your behalf, without additional work from you. There are some payers, however, that require steps only you can complete. This guide contains comprehensive instructions for how you can complete the steps such payers require.

The Verified team is available at any time to assist. Don’t hesitate to reach out to us at Support@Verified.inc or on Slack, and we’ll help in any way we can.

Completing These Enrollments is Optional

You can ignore instructions for any payer that's irrelevant to your use case or that has steps you deem too burdensome. The downside is simply that we won’t be able to autofill health insurance data for users of such a payer.

Medicaid

Iowa

Processing Time	2 weeks (handled by payer)
Payer Name	Medicaid Iowa
Payer Verified ID	V183310
Other Payer IDs	18049, IAMCD, IACAID, 100171, 1469, 1665, GZVQX, 10107, SKIA0

tip

For this payer, you need to complete enrollment through EDISS Connect (Electronic Data Interchange Support Services). Register for an EDISS account if you don't have one already, and reach out to them if you have any issues: +1 (800) 967-7902.

note

We use FinThrive Health as an intermediary to connect with this payer.

1. Log in to EDISS Connect.
2. Click the Add Transactions tab.
3. For each NPI you have, enter the NPI and associated Tax ID and click Continue.
4. Select Iowa as the state for transactions, and then click Add and Continue.
5. Select the Type(s) of transactions you will be submitting: Institutional, Professional, and/or Dental.
6. Choose the Lines of Business that apply to your NPI(s) and click Continue.
7. Check the Enroll box next to 270 Eligibility Benefit Inquiry and click Add Vendor.
8. Select FinThrive Health (AC101397) as your vendor, and then click Add and Submit. You should arrive at a Summary page that indicates if you need to complete any additional enrollment forms.
9. Tell Verified you've completed this payer enrollment, so we can finalize it on our side.

important

The last step — telling Verified you've completed the payer enrollment — is required. We need to finalize it manually on our side. You can reach out to us at Support@Verified.inc or on Slack.

Michigan

Processing Time	2 weeks (handled by payer)
Payer Name	Medicaid Michigan
Payer Verified ID	V652160
Other Payer IDs	RFUPF, CKMI1, 2480, MIMCD, 6109, 10392, 2137, SKMI2, D00111, 4581, 10136, MICAID, SKMI0

tip

For this payer, you need to complete enrollment through CHAMPS (Community Health Automated Medicaid Processing System) via MiLogin for Business. Register for a MiLogin for Business account if you don't have one already, and then register for CHAMPS if you haven't already. Refer to the CHAMPS user guide and CHAMPS training resources (accessible at the bottom of the portal page), and reach out to them if you have any issues: +1 (800) 292-2550, providerenrollment@michigan.gov.

note

We use ClaimRemedi as an intermediary to connect with this payer.

1. Log in to MiLogin for Business.
2. Click CHAMPS to access the CHAMPS portal.
3. Start the enrollment process and select New Enrollment.
4. Under the Providers tab, click Manage Provider Information to access the Business Process Wizard.
5. For each NPI you have, complete all steps of the Business Process Wizard in order, and click Close.
6. Click Associate Billing Agent and click Add.
7. Enter 1206586 as the Billing Agent ID and click Confirm/Search. You should see ClaimRemedi appear as the Billing Agent Name.
8. Tell Verified you've completed this payer enrollment, so we can finalize it on our side.

important

The last step — telling Verified you've completed the payer enrollment — is required. We need to finalize it manually on our side. You can reach out to us at Support@Verified.inc or on Slack.

Utah

Processing Time	6 weeks (handled by payer)
Payer Name	Medicaid Utah
Payer Verified ID	V308074
Other Payer IDs	10648, 1486, NLWNP, UTCAID, CKUT1, UTMCD, UDOH0, SKUT0, TNJBD

tip

For this payer, you need to complete enrollment through PRISM (Provider Reimbursement Information System for Medicaid) via the PRISM Provider Portal. Register for a PRISM account if you don't have one already, using the application ID the payer included in letters they mailed to you. If you don't have an application ID or have any other issues, reach out to them: +1 (801) 538-6155, providerenroll@utah.gov.

note

We use UHIN as an intermediary to connect with this payer.

1. Log in to the PRISM Provider Portal.
2. Under My Profile on the left, click Manage Provider Information to open the Business Process Wizard.
3. Complete all steps marked as required in the Business Process Wizard:
   • Step 8 (Mode of Claim Submission/EDI Exchange):
     1. Check the box by Mode of and Billing Agent/Clearinghouse/UHIN (under the header of EDI Exchange - Billing Agent/Clearinghouse/UHIN). Don't select Electronic Batch.
     2. Select 270/271-Eligibility as the transaction and click the right arrow button (under the Associated Transactions column).
     3. Click the OK button (near the bottom of the page).
   • Step 9 (Associate Billing Agent):
     1. Click the Add button on the Billing Agent List page.
     2. Click the Confirm/Search Billing Agent button.
     3. Click the Filter By dropdown, select Billing Agent Name, enter UHIN, and click Go.
     4. Click the check box next to UHIN and click the Select button. You'll be taken back to the Associate Billing Agent page.
     5. Add the current date for Association Start Date.
     6. Click the Add button (under the EDI Transaction Authorization header).
     7. Click the Electronic Transaction Type dropdown and select 270/271-Eligibility.
     8. Enter HT006748-001 for Trading Partner ID and click the OK button. You'll be taken back to the Associate Billing Agent page.
     9. Click the OK button again.
   • Step 17 (Submit Modification Request for Review): Submit your application.
4. Tell Verified you've completed this payer enrollment, so we can finalize it on our side.

important

The last step — telling Verified you've completed the payer enrollment — is required. We need to finalize it manually on our side. You can reach out to us at Support@Verified.inc or on Slack.