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Not all Payers require enrollment to submit claims. Inovalon maintains a list of Payer IDs that require enrollment or not which you can find here : https://www.inovalon.com/payer-list/#tab-1713242307909-0When you click this link, you’ll see three tabs. Be sure you’re on the first tab ( Claims Management Pro Payer List) as shown in the image belowportal:

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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.

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If you previously used Change Healthcare and are transitioning to Inovalon, you will need to review your Payer IDs set within MacPractice to ensure they match Inovalon’s Payer ID list. If you do not do this, you may experience claim rejections due to incorrect Payer ID. You can update Payer IDs by navigating to your Insurance Company References in the References Ability, and select each Insurance, and update the Payer IDs to match Inovalon’s list. Below is a screenshot of the exact field you’ll want to update. While you’re in here, you will also want to ensure that there are no special characters in the Insurance Company name. (No parentheses or other symbols, just alphanumerical characters)

Setting up Entities

First, you’ll need to set up your Entities to confirm that they are correct. These refer to your Billing Entities, the Facilities and Physicians that you will be billing under.

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If you find yourself in the situation where you have failed enrollments, we first recommend that you revisit the Entity Table in the prior section (Insert link here) to confirm that your Entities are configured properly and all data is entered as expected before proceeding with these steps.

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