...
When you first log on to the Claims Management Pro portal after setting up your account, you’ll find yourself on the front page of the Inovalon One Portal. You can also visit this site via the following URL:
https://providercloud.inovalon.com/
...
When launching Claims Management Pro for the first time, you’ll probably see this alert containing legal notices about the usage of CPT. Feel free to peruse and click “I Accept” whenever you are ready.Once you click I Accept, you’ll find yourself on Claims Management Pro’s main page. This is where we’ll start enrolling for our payers
What Payers Do I Have to Enroll With?
Inovalon maintains a Payer ID list here:
https://www.inovalon.com/payer-list/#tab-1713242307909-0
When you click this link, you’ll see three tabs. Be sure you’re on the first tab as shown in the image below:
...
If you scroll down, you’ll see a preview of the PDF that contains the Payer List. In the rightmost column of this Payer ID list, you’ll see “Enrollment Required (Y/N)”. This indicator tells us which Payers require you to enroll with them before you submit your claims to them.
Mass Enrollment Process in Claims Management Pro
...
This will bring you to the Enrollment Requests page. In the upper right hand corner above the table, you can see a “Create New Request” button, as shown in the image below. Click this button.
...
From here, you can either enroll facilities/physicians, or payers. For our purposes, we’ll pick “Facilities / Physicians”.
...
Adding Facilities and Physicians
When you choose the Facilities/Physicians button, you will be taken to the screen to add your facilities or physicians for enrollment. In the upper right-hand corner, you will notice two buttons to add the pertinent enrollment information.
...
You have the option to select multiple facilities or physicians from this list, which allows you to create multiple enrollment requests simultaneously. To select a facility/physician, click the checkbox next to the entities you wish to enroll and click Apply in the bottom right-hand corner of the screen. After adding all the facilities/physicians you need to enroll, click the Continue button in the bottom right-hand side of your enrollments screen as shown below.
...
Adding Payers to Enroll To
You will now be moved to the Payer Selection screen.
...
To correct this error, click the blue text which takes you to your entity table configuration for
the failed enrollment’s entity record. You will then update the information as appropriate,
based on the information in the previous dialogue box and click Save.
Once this has been completed, you will then migrate back to the Enrollment Data
Validation Failed screen and click the Revalidate button
...
| Info |
|---|
Note: After revalidation and the enrollment request has “passed,” the record will reflect a green PASSED icon on the enrollment in the Validation Status column. |
...
If you decide not to move forward with this enrollment, you can click the Cancel button on the bottom left hand corner this screen.
13. Once you have created your enrollment requests and all have “passed” validation, you can now click the Submit button in the bottom right-hand corner of your screen.
Your enrollment requests have now been submitted and appropriate instructions will be emailed to you within 24 hours.
...
...
Cancelling Pending Enrollments
If you find yourself in the situation where you need to cancel any pending enrollments, you can follow these steps:
Navigate to the View Status screen.
Settings > Inovalon Enrollment > View Status
Navigate to the enrollment you wish to Restart via the Profiler or the Quick Search options at the top of the Enrollment Status screen. To restart an enrollment, simply click Magnifying Glass icon located in the Action column on the Enrollment Request grid.
The Enrollment Request Detail dialogue box will populate. Choose the Restart button in the bottom right-hand corner to restart this enrollment.
You will then be redirected to the Create Enrollment Request screen and will click the Review button in the bottom right-hand corner of the Facility selection screen.
You will now notice that the Validation Status reflects a “Duplicate” status. Click on the blue “i” icon in the Action column on the right and the Enrollment confirmation dialogue box populates.
In this screen, you will now click the Yes, Submit All button to allow this enrollment to be restarted.
...
The Validation Status will now update to Passed and you can select the Submit button in the bottom right-hand corner of your screen to successfully transmit your new enrollment request.
...
...
Checking Status
...
of Enrollments
Navigate to the Inovalon Enrollment View Status Screen. •
Settings -> Inovalon Enrollment → View Status
...
Your Enrollment Requests grid also has the option to populate multiple columns of information for each individual enrollment request (If you find you need a new column, you can click the Update Columns button and choose other data columns you wish to display in the default view).
The Select Columns dialog box will open. You can then click the available checkboxes to add or remove any data you would like to view on your enrollment view status grid. You can also reorder the columns by clicking the selections on the left and moving them to the order you would like to see them. Once completed, you can click Save and your grid view will be updated.
Once you have filtered your enrollment requests and have your columns view set to your preferences, you can now view additional detail for each enrollment, if necessary.
To View an individual enrollment request’s history, you can choose the Magnifying Glass icon in the action column.
Once selected, an Enrollment Request dialog box appears with historical and current status information for the enrollment.
Enrollment Status Message Meanings
Based upon the status of your enrollment request, you should be able to discern next steps, if any, on how to complete your enrollment or view its current state.
Status | Status Description | Activity (Latest) | Next Step Owner | Next Step |
|---|---|---|---|---|
FAILED | Failed to Initiate Enrollment Process | (None) | Customer | Verify Entity Table information and restart enrollment |
On Hold | ERA Enrollment on hold | (None) | Customer | Claims for the ERA payer must be submitted through Claims Management before ERA Enrollment will release for enrollment task creation. |
SCHEDULED | Scheduled for Processing | (None) | Automatic Process | Enrollment task will be created and sent to Enrollment Contact in Entity Table for completion, if required. |
PENDING PROVIDER | In Progress | Task or Signature Request Sent to Provider OR Inovalon reached out to Provider for Follow- up. | Customer | Complete paperwork/instructions sent by Enrollment Team. |
PENDING PAYER | In Progress | Request/Form Sent to Payer | Inovalon Enrollment | Enrollment team to track progress with the Payer. |
APPROVED | Successfully Completed | Request Approved by Payer OR Request Auto- Approved Without Payer Confirmation | NONE | NONE |
REJECTED | Request Rejected by Payer | Request Rejected by Payer. Reason: | Customer | Review rejection. Correct any missing/invalid data and re-enroll. If you do not wish to re-enroll, ignore rejection. |
CANCELLED | Cancelled | Canceled by: (Varies) Reason: (Varies) | Customer | Confirm if enrollment needs to be restarted or truly not needed due to wrong plan, wrong transaction type, etc. |
...
be restarted or truly not needed due to wrong plan, wrong transaction type, etc. |
Inovalon Enrollment Portal
Separate from Claims Management Pro, the Enrollment Portal is used to track your enrollments with the various payer IDs from the prior section.
Logging into the Enrollment Portal
...
You are required to open and review the document before you can submit the request.
f. Notes:
i
...
.
...
If you notice an error on the form, choose Report Form Problem. This will cancel the enrollment and create a ticket for Madaket to review. Once the issue is corrected, a task will appear back in your work queue for completion.
ii. You will also have the option to enter a Packet ID if supplied by the payer.
Upload Enrollment Form - Physical Signature May Be Required
...