Updating an ERA X12 835 Information - Provider Web Portal Quick Guide

Updating an ERA X12 835 Information

The ERA X12 835 enrollment can only be completed after provider enrollment. ERA X12 835 enrollments will no longer occur on the "Link Registered Trading Partner ID for X12 Reports" tab in Manage Accounts. All other X12 transaction delegations will still occur in Manage Accounts.

1. Login to Provider Web Portal
2. Click EFT/ERA (835) Enrollment link

   Click the "EFT/ERA (835) Enrollment" link on the left-hand side of the home page.

   
3. Click ERA (835) Enrollment Application link

   Click the "ERA (835) Enrollment Application" link on the left-hand side of the page.

   
4. Click Continue
   
5. Complete all required fields and click Continue

   Use this section to initiate a new ERA X12 835 enrollment, change the receiving trading partner ID of the existing ERA X12 835 enrollment, or cancel an existing ERA X12 835 enrollment.

   • For a New or Change Enrollment required fields are: Provider Name, Tax ID, NPI (if issued), Trading Partner ID, Provider Contact information (Name, Phone, and Email) and Reason for Submission.
     Note: For a Change Enrollment, use the new Trading Partner ID.
   • For a Cancel Enrollment required fields are: Provider Name, Tax ID, NPI (if issued), Provider Contact information (Name, Phone, and Email) and Reason for Submission.
   

   Use the "Reason for Submission" dropdown to indicate a New Enrollment, Change Enrollment or Cancel Enrollment.

   
6. Sign the Agreement.

   Complete the required fields and then click Review.

   

   Print and save a copy and then click Submit.

   

   New ERA information should go into effect right away. The ERA X12 835 will be received after the next financial cycle that includes claim activity.

   Updates to an ERA X12 835 enrollment can be made using the "ERA (835) Enrollment Application" link. The ERA X12 835 enrollment option on the "Link Registered Trading Partner ID for X12 Reports" tab in Manage Accounts will be greyed out. See the red arrows below.

   Refer to Steps 3-6 above for instructions on accessing and completing the "ERA (835) Enrollment Application" link.

   

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