Enrollments

The “Enrollments” module in MedTrainer Credentialing is the workflow engine that manages the submission and tracking of provider (or group) applications to payer networks and other credentialing entities — integrating document collection, automated packet generation, status monitoring, and analytics in one system to reduce processing time, minimize denials, and keep revenue flowing.

Enrollments - User Guide

FAQs

What are enrollments?

Enrollment is the process of formally applying for a Provider or Group to be contracted and accepted by a specific Insurance/Payer organization.

How to add insurance from the MT catalog?

Click the "Insurances" module under the Credentialing sidebar menu.
Click the "Add insurance from MT catalog" button.
Type the name of the insurance into the Search field.
Select the required insurances from the list.
Click the "Save" button to complete the configuration.

How to add Insurance that does not appear on the existing listing?

Click the "Insurances" module under the Credentialing sidebar menu.
Click the "Create custom insurance" button.
Fill in the Mandatory Fields.
Configure LOB Products if required.
Click the "Save" button to save the custom insurance configuration.

How to configure locations for my insurances?

From the Insurances module:

Click the Locations column for the insurance to modify.
Select the required credentialing locations.
Click elsewhere on the screen to close the dropdown.

From the Locations module:

From the "Credentialing locations" module, click the "+ Multiple setup" button.
Select the "Enable insurances in multiple locations" option.
Select the Locations where you want the insurances to be configured.
In the Available Insurances list, type the name of each Insurance into the Search field.
Select the insurances to be configured.
Click the "Save" button to complete the bulk configuration.

How to add enrollments?

For a single provider:

Navigate to the Provider profile and access the Enrollments tab.
Click the "New enrollments" button.
Select Insurances:
1. Click the "Insurances" button.
2. Select the insurances from the configuration table.
3. Click the "Save" button.
Configure Enrollment Details (Select values for fields like State, Tax ID, Locations, etc.).
Click the "Save" button.

For multiple providers:

Navigate to the Provider enrollments module.
Click the "New enrollments" button.
1. Click the "Insurances" button.
2. Select the insurances from the configuration table (You can filter by location or catalog type).
3. Click the "Save" button.
Configure Enrollment Details (Select values for fields like State, Tax ID, Locations, etc.).
Select all providers for whom the enrollments will be created.
Click the "Save" button.

For groups:

Navigate to the Group enrollments module.
Click the "New enrollments" button.
Select Insurances:
1. Click the "Insurances" button.
2. Select the insurances from the configuration table.
3. Click the "Save" button.
Select the Tax ID from the configured Business entities catalog.
Configure Enrollment Details (Select values for fields like State, Enrollment NPIs, Locations, Services covered, etc.).
Click the "Save" button.

How do I add documents to the enrollments?

From the enrollment detail screen, select the Documents tab.
Click the "Create document container" button.
Select Document Type.
Upload File.
Click the "Create" button to save the document.

How do I link provider documents to the enrollments?

From the enrollment detail screen, select the Documents tab.
Click the "Link existing document container" button.
Select Documents.
Click the "Link" button to add them to the Related provider documents table.

How to modify Enrollment status or Workflow state for a single enrollment?

Enrollments can be modified in 3 ways.

Option 1: When accessing from the Providers module

Log in at MedTrainer
Select MT Credentialing > Providers
Select the Provider you wish to access
Select the Enrollments tab
Select the Insurance that is desired for modification
Select the View detail icon
Modify the fields as necessary

Option 2: When accessing from the Provider enrollments module

Log in at MedTrainer
Select MT Credentialing > Provider enrollments
Search for the Provider enrollment that is desired for modification.
Select the View detail icon.
Modify the fields as necessary

Option 3: When accessing from the Group enrollments module

Log in at MedTrainer
Select MT Credentialing > Group enrollments
Search for the Group enrollment that is desired for modification.
Select the View detail icon.
Modify the fields as necessary

For additional information on the Enrollment status or Workflow states, see the user guide.

How do I create a note related to the enrollment?

Enrollment notes can be added 2 different ways:

From the enrollment detail:

Select the Notes tab.
Click the Add note button.
Input all desired/required information
Click at the Save button.

From the enrollment tables:

Select an enrollment.
Click at the Add note action.
Input all desired/required information
Click at the Save button.

Will Providers receive an email notification regarding their enrollment?

The Approved, Rejected and Terminated statuses configuration allows the user to submit an email notification to the provider to inform them about the Insurance company resolution regarding the enrollment application.

These are the notifications that are sent according to each case:

Approved
Rejected
Terminated

What are the names of the enrollment datasets available?

Enrollments locations in a cell
Enrollments one row per location
Enrollment notes
Enrollment locations
Enrollment products
Enrollment payers

These datasets are available for both provider and group enrollments.

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