The Enrollment tab in Provider Profile provides a general idea of where the current enrollment application stands and its workflow state, per payor & provider.

The Enrollment workflow management model uses Enrollment Status, Workflow States and Priorities to allow Admins to clearly identify what needs to be done and which enrollment applications must be attended first.

Enrollment applications refer to the process of requesting a Provider to be enrolled with a particular Insurance/Payer. 

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Locations
Step 3: Select the location (select the bubble)
Step 4: A blue ribbon will appear, select the building icon (information icon)
Step 5: Select the Set-Up Insurances tab
Step 6: Select the insurances in the Available Insurances column (left)
Step 7: Confirm the needed insurances are in the enabled insurances column (right)
Step 8: Select Save

If the required Insurance does not exist please contact support@medtrainer.com.

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Provider Profile
Step 3: Select the Providers you wish to access
Step 4: Select the Enrollments tab
Step 5: Select the + Create Enrollment button
Step 6: Select the Location(s) to enable the Insurances associated to that location
Step 7: Select the Select All box
Step 8: Select the Continue button 

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Provider Profile
Step 3: Select the Providers you wish to access
Step 4: Select the Enrollments tab
Step 5: Select the Insurance you wish to add a document(s) too 

Step 6: Select View detail
Step 7: Select Add Document
Step 8: Fill in the fields that pertain to the document
Step 9: Select Upload

Enrollment applications can be modified in 2 ways.

Option 1: When select mt | credentialing > Provider Profile

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Provider Profile

Step 3: Select the Provider you wish to access

Step 4: Select the Enrollments tab

Step 5: Select the Insurance that is desired for modification

Step 6: Select the View detail icon

Step 7: Modify the fields as necessary  

Option 2: When you select mt | credentialing > Enrollments 

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Enrollments 

Step 3: Search for the Provider & Enrollment application that is desired for modification
Step 4: Select the View detail icon

Step 5: Modify the fields as necessary  

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

Note: If the required document does not exist please contact support@medtrainer.com.

• Onboarding
  Used when the admin is performing the initial research with the payer to identify if the provider is already enrolled or if the enrolling application needs to be performed.
  
  

• Enrolling
  Used when the Onboarding has been concluded, and the admin requires to submit the application form and the additional required documentation to the payer.
  
  

• Recredentialing
  Used when an Approved enrollment is expiring and needs to go through the enrolling application again.
  
  

•  Approved
  When the payer has approved the application form from the provider and the admin has the Contract effective date and a Recredentialing date.
  
  

• Rejected
  Used when the enrollment application has been rejected for any reason
  (e.g., the market is closed for the provider’s position with the payer).
  
  

• Appealing
  When the enrollment application was terminated due to a payer decision and the admin wants to appeal the payer’s decision.
  
  

• Terminated
  When the enrollment application has been terminated for any reason
  (e.g., the provider is ending its job relationship with the company).

• In Queue
  The initial state of the workflow & is intended for admins to identify that the application is in an idle state.
  
  

• In Progress
  Indicates that the enrollment is currently being handled by an admin.
  
  

• Ready for Submission
  Indicates that the enrollment form and documentation are ready to be submitted to the payer.
  
  

•  Waiting for Payer
  Indicates the application is stopped due to an action pending from the payer.
  
  

• Waiting for Provider
  Indicates the application is stopped due to an action pending from the provider.
  
  

• Waiting for Approval
  The application is stopped because an approval is required.
  
  

• Dependent Enrollment
  Indicates the enrollment has a dependency with another enrollment.
  
  

• Finished
  Used when the enrollment application has reached its conclusion: Approved or Rejected result.

Priorities are useful for admins to have visual aid on which enrollments require their immediate attention. The priorities are:

• 1 Very High

• 2 High

• 3 Medium

• 4 Low

• 5 Very Low

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Provider Profile

Step 3: Select the Provider you wish to access 

Step 4: Select the Enrollments tab

Step 5: Select the Insurance you wish to add a note too 

Step 6: Select View detail

Step 7: Select the Notes tab

Step 8: Select + Add note button

Step 9: Input all desired/required information

Step 10:  Select Save

Additionally, whenever an enrollment application's Status or Workflow state is modified, the system allows to enter a user note.

Step 1: Log in at MedTrainer 

Step 2: Select MT Credentialing > Provider Profile

Step 3: Select the Provider you wish to access 

Step 4: Select the Enrollments tab

Step 5: Select the Insurance you wish to add a task too 

Step 6: Select View detail

Step 7: Select the Tasks tab

Step 8: Select Add Task button

Step 9: Input all desired/required information

Step 10:  Select Save

Super Admins and Admins only.

Step 1: Log in at MedTrainer 

Step 2: Select mt | credentialing

Step 3: Select Enrollments

Step 1: Log in at MedTrainer 

Step 2: Select mt | credentialing > Enrollments

Step 3: Select Provider & their associated Insurance you wish to access
Step 4: Select the View Detail icon

The Credentialing Dashboard provides Admins a comprehensive overview of the performance, highlights and possible risks regarding the enrollment process of their Providers.

The dashboard is formed by collapsible sections and widgets. 

Each section will hold a predefined amount of widgets. Each widget will display data pertaining to the enrollment applications in the form of:

• • Pie charts

  • Gauge charts

  • Tables

  • Line graphs

Super Administrators & Administrators.

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

These notifications are also available for configuration at the Notifications setup module.

The email notification will include a list (titles) of documents expiring or that have been expired. 

1.  Global enrollments report

2. Comprehensive enrollments report

3. Plain credentialing report for enrollments

4. Provider Profile Enrollments tab (Export report)

The email notification cadence: 

• Prior to expiration date: 90, 60, 30, 10

• On the expiration date

• After the expiration date: The system will send daily reminders (notifications via email)