When enrolling with Apex Clearinghouse, a Provider may not know how to enroll.
You should enroll based on how you are credentialed with you Payers. If you are unsure how you should enroll, you can search the NPI Registry site. What is listed on the NPI Registry is what needs to be submitted.
You will then complete the Enrollment Survey based on that credentialing. You may need to fill out the Enrollment Survey more than once depending on how you are credentialed with different Payers. For example, you may be credentialed as a Type 2 (Group) with one Payer and then as a Type 1 (Individual) with another. See below for an example.
See below for for helpful definitions and links to articles that will walk you through Enrollment:
- Type 1 NPI (Individual) - This is typically for Healthcare Providers who are individuals and sole proprietors. An individual in eligible for only one NPI.
- Type 2 NPI (Group) - This is typically Healthcare Providers who are Organizations, including Physician Groups, and the corporation formed with an individual incorporates him/herself.
- Combination Enrollment - You may be credentialed with some Payers as a Type 1 and some as a Type 2. This would require a Combination Enrollment.
Example
My Payers are BCBS, Medicare, and Tricare.
I'm credentialed as a Group with BCBS but Individual with Medicare and Tricare.
Therefore, I will complete the Enrollment Survey process with my Group NPI (Type 2) for BCBS.
Then I will then return to the Enrollment Survey to complete it with my individual NPI (Type 1) for Medicare and Tricare. Again, this means I completed the Enrollment Survey two separate times - each way for how I'm credentialed with my payers.
Related Articles
- WebABA Claims FAQs
- Prepare for Enrollment
- Should I Enroll as a Type 1 or Type 2?
- Apex Enrollment Survey FAQs
- Change Healthcare Enrollment FAQs