Electronic Data Interchange (EDI)




WPS Health Solutions EFT/ERA Resources


Get paid faster and reduce administrative paperwork with electronic funds transfer (EFT) and electronic remittance advice (ERA).

To set up or change EFT/ERA with multiple payers, you may use EnrollHub™, a CAQH EFT/ERA Solution™.

A valid WPS EDI Trading Partner ID is required to ensure timely processing of your ERA

Please note that EFT/ERA for the Medicare and TRICARE Overseas payers is not managed through EnrollHub™.

Enroll



About EFT

When you enroll in EFT, WPS claims payments are deposited directly in the bank account(s) of your choice.

EFT Payment transactions are reported with file format CCD+, which is the recommended industry standard for EFT payments. The CCD+ format is a NACHA Automated Clearing House (ACH) corporate payment format with a single, 80-character addendum record capability. The addendum record is used by the originator to provide additional information about the payment to the recipient. This format is also referenced in the ERA 835 data file). Contact your financial institution if you would like to receive this information. Fees may be associated with EFT payments. Consult with your financial institution for specific rates.


About ERA

The ERA replaces the paper version of the Remittance Advice (RA). WPS delivers 5010 835 versions of all remittance files that are compliant with the Health Insurance Portability and Accountability Act (HIPAA). You can receive your ERA directly from WPS or through your clearinghouse.

Fees may be associated with ERA transactions. Check with your clearinghouse for specific rates.


Multipayer EFT Enrollment Through CAQH

NOTE: This information does not apply to the TRICARE Overseas or Medicare payers. Information about EFT/ERA enrollment for those payers is provided in separate sections below.

Practitioners who want to sign up for electronic funds transfer (EFT) payments from multiple health plans (WPS and others) can do so through EnrollHub™, a CAQH EFT/ERA Solution™.

With EnrollHub, you submit EFT enrollment information to CAQH online. CAQH verifies the information and then sends it to WPS and the other payers you select. These payers process your enrollment and begin sending electronic payments to your bank account. There is no enrollment cost for the provider.

Following the EFT enrollment process, you can also enroll to receive electronic remittance advices (ERAs). When you enroll, you will be prompted to designate who should receive your ERA (yourself or a third party).

Fees may be associated with electronic transactions. Check with your financial institution for specific rates related to EFT. Check with your clearinghouse for fees related to ERA.

To enroll, visit https://solutions.caqh.org and follow the three steps listed on the Web page.


Medicare EFT/ERA Enrollment

Practitioners who want to sign up for electronic funds transfer (EFT) payments from Medicare can do so by completing and submitting a Form CMS-588 or through PECOS.

Practitioners who want to sign up for Electronic Remittance Advice (ERA) from Medicare can do so by completing and submitting a Form through WPS GHA Portal


TRICARE Overseas EFT/ERA Enrollment

Practitioners who want to sign up for electronic funds transfer (EFT) payments from TRICARE Overseas should visit www.tricare-overseas.com/providers/resources/provider-forms for more information.

Electronic Remittance Advice (ERA) Enrollment coming soon!



WPS Health Solutions


Frequently asked questions about EFT registration through EnrollHub™

1. What is the CAQH EFT enrollment option?
EnrollHub™, a CAQH EFT/ERA Solution™, is a tool that enables physicians and other health care providers to sign up for electronic payments via electronic funds transfer (EFT) from multiple health plans or payers in one place, rather than enrolling individually with each payer. For a list of participating payers, visit CAQH.org.

2. What is CAQH?
CAQH is a nonprofit alliance that creates solutions to streamline health care business processes. The alliance is known for CAQH ProView™, formerly the Universal Provider Datasource®, a solution which facilitates data collection for credentialing and other administrative processes.

3. How can I enroll?
To get started, submit enrollment information through the CAQH website at http://solutions.caqh.org. CAQH verifies the information and then sends it to the participating payers you selected. You can monitor the status of your enrollment and make updates through the CAQH system.

4. What do I need to have available during sign-up?
You will need an Internet connection and web browser, plus the following: • Practice/facility information – tax ID (TIN or EIN), national provider identifier (NPI), contact information and e-mail address. • Bank information – routing number, account number, and a voided check or bank letter image.

5. Will CAQH send me payments from the health plans?
No. This is only an enrollment tool. Payments will continue to be made directly from WPS (or the appropriate payer), but these payments will be made electronically to the bank account(s) you indicated when signing up with EnrollHub.

6. What costs are associated with EnrollHub and EFT/ERA?
There’s no fee to use EnrollHub. To determine if fees apply to your EFT/ERA transactions, check with your clearinghouse and financial institution.

7. How can I learn more?
For more information about the EnrollHub process, visit the CAQH website at www.caqh.org and look for the “Solutions” tab at the left of the page.

8. How can I get help with the CAQH tool?
You may send an e-mail to efthelp@enrollhub.caqh.org or call the CAQH EFT Enrollment Help Desk toll-free at 1-844-815-9763. Assistance is available Monday through Thursday from 7 A.M. to 9 P.M. Eastern time and Friday from 7 A.M. to 7 P.M. Eastern time.












Need Help?
For questions about online registration, password resets, how to login,
missing files or any other technical concerns:
 

For help with Medicare J5 Part A/B:
Please call: 1-866-518-3285 Option 1

For help with Medicare J8 Part A/B:
Please call: 1-866-234-7331 Option 1

For help with TRICARE, VA, WPS Health Insurance(private),
Family Care and Children’s Waiver Program, Arise:
Please call: 1-800-782-2680 Option 1
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