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Submitting the Online ERA Enrollment authorizes any of the following insurance companies to submit electronic remittance advice to the named provider.
Please allow two weeks for the enrollment process. If after two weeks you do not start receiving ERA files, please contact us at edi_helpdesk@cnoinc.com. You may also email us with enrollment questions or requests for a paper copy of the ERA Enrollment form. ERA files that have not been received after four business days of receipt of the corresponding EFT payments can be researched by sending an email to edi_helpdesk@cnoinc.com. Instructions for Completing Electronic ERA Enrollment Below describes each field displayed on the Online ERA Enrollment screen. Fill out each section and click "Submit" once finished. To enroll multiple National Provider Identification Numbers with the same Tax Identification Number, please click "Next" at the bottom of the screen. If you wish to exit the enrollment screen without submitting or saving your information, click "Cancel". Provider Information Provider Name- Complete legal name of institution, corporate entity, practice or individual provider.Physical Address- Number and street name where a person or organization can be found. City- City associated with provider address field. State- State of the applicable Country Zip Code- 5 digit zip code Provider Identifiers Information Tax Id Number- The provider's Tax Identification Number (TIN)NPI- The provider's National Provider Identifier (NPI) Trading Partner ID- The provider's submitter id assigned by the provider's clearinghouse or vendor (if applicable) Provider Contact Information Provider ERA Office Contact Name- Name of a contact in provider office for handling ERA issue.Title- Title of the person listed as provider contact. Telephone Number- Associated with contact person. Email Addresses- An electronic mail address at which the health plan might contact the provider. Electronic Remittance Advice Information Provider Preference For Grouping Claim Payment Remittance Advice- must match preference for EFT payments. Must choose one of the two options: Tax Identification Number (TIN) or National Provider Identifier (NPI), and input the corresponding identification number.Method of Retrieval- The method in which the provider will receive the ERA files from us if not using clearinghouse or vendor. Electronic Remittance Advice Clearinghouse/Vendor Information Clearinghouse/Vendor Name- Official name of the provider clearinghouse/vendorContact Name- Name of person at the clearinghouse or vendor to contact Telephone Number- Telephone number of the contact person Email Address- An electronic mail address of contact at the clearinghouse or vendor Submission Information Reason for Submission- Must select one of three options: New Enrollment, Change Enrollment, or Cancel Enrollment Authorization By checking the displayed box, the provider attests that they are a duly authorized representative of the provider named above and possess the requisite authority to request an electronic remittance file from CNO Services LLC. Printed Signature- Name of user submitting the EFT Enrollment request. |
