So, you've completed all of your initial enrollments (EDI for claims; ERA for electronic remits; and RTE for real-time eligibility, if required) but now need a few more. How do you proceed? With TriZetto's STEM portal, the process is very easy!
All you need to do is first verify that the service you are requesting is available for that particular payer and that enrollment is required.
For example, some payers do not offer ERAs or provide RTE checks.
This link will take you to TriZetto's Gateway EDI Payer List (professional claims) where you can check to see if 1) the service is available and 2) if enrollment is required.
Here is an example of how a payer will look on TriZetto's payer listing:
(Information listed in the above chart is correct as of the day it was pulled and is for informational purposes only. Changes can be made by the payer at any time. Please check the TriZetto payer listing for the most updated information.)
The payer's name is listed on the left, which states the plan is available, directly underneath. In the chart, you will also find the electronic payer ID and listing of available transactions (claims/EDI, ERA, RTE, etc). If you hover your cursor over the icon in the "Available Transactions" column, it will tell you exactly what the icon represents.
If the service is available and enrollment is required, all you need to do is enter the request into the TriZetto STEM portal, using your username and password. The request will process exactly the same as it did when you initially set up your payers with TriZetto. Any additional documents required by the payers to complete the request will be available in your STEM portal. You will also be able to check the status of your request in real-time.