How Can I Tell If a Payer Requires Enrollment and If Enrollment is Required, How Do I Enroll?

Payers may require enrollment before you can exchange certain transactions with them. To check whether enrollment is required for a specific Payer and Transaction as well as how to enroll, follow these steps:

Accessing and Completing Payer Enrollment Requirements:‍

1. Access the Payer List:
   • In Service Center, navigate to the Resources section on the left side of your screen and select Payer List.
     -OR-
   • Click on Ally Central (the blue question mark in the bottom-right corner of the screen).
   • Select Resource Library, then click on Office Ally’s Payer List.
2. Search for the Payer:
   • In the Payer List, search for the Payer Name/Payer ID and the specific Transaction you wish to verify.
   • Transactions include:
     • Professional Claims 837P
     • Institutional Claims 837I
     • Dental Claims 837D
     • Remits 835
     • Eligibility 270/271
     • Claim Status 276/277
   • Once you locate the record for the specific Payer and Transaction, you’ll see an exclamation mark in the ENROLLMENT column if the payer requires enrollment for that transaction.
   • Please be sure to check the "Notes" column for any special enrollment requirements/information.
3. Enroll if Necessary:
   • If enrollment is required, access the corresponding Enrollments page depending on the Transaction type.
4. Access the appropriate Enrollment Page:
   • Click on Ally Central (the blue question mark) and select Resource Library.
   • For Claims, Eligibility or Claim Status Transactions, select Payer EDI Enrollment Forms
   • For Remits, select Payer ERA Enrollment Forms.
5. Locate and complete the Enrollment:
   • Locate the enrollment on the enrollment page.  
   • Follow the provided instructions to complete the enrollment process.

IMPORTANT NOTES:
Claims Enrollment: Review the HOW DO I CHECK STATUS? section carefully to determine whether you can begin submitting claims immediately after being approved or if further communication with Office Ally is required before submitting your first claim to the payer.
Remits: Some payers may return the ERA/Remit automatically to the clearinghouse that submitted the claim, eliminating the need for remit enrollment. For payers that do this, you’ll see this detailed in the Notes column of the Payer List.
By following these steps, you can easily determine whether a payer requires enrollment for a specific transaction and locate instructions on how to complete the necessary enrollment process to exchange that transaction with that payer.