Interpret Enrollment Statuses

Overview

This article helps you understand the enrollment status badges shown in Your Payers. You may need this when you are deciding whether a payer is ready for eligibility checks.

Before you begin

• You need access to Config > Eligibility > Your Payers.

Steps

1. Open Your Payers.
2. Find the row you want to review.
3. Look at Enrollment Status.
4. Treat Ready as eligible to run checks.
5. Treat Enrolled as eligible to run checks.
6. Treat Pending as not ready yet.
7. Treat Enrollment Required as not ready yet.
8. Treat Not Supported as unavailable for eligibility checks.
9. Treat Not Mapped as needing a payer mapping first.
10. Treat Unknown as a mapping that still needs enrollment status to sync.

Troubleshooting

• If a row shows Unknown after a mapping change, then wait for the clearinghouse sync to update the enrollment status.
• If a row stays Pending, then the enrollment is still in process with the clearinghouse.
• If a row stays Enrollment Required, then the payer requires enrollment and your organization has not completed it yet.
• If a row should be ready but shows the wrong status, then confirm the payer mapping is correct first.