How does Provider Validation work on the Enrollments page?

Prev Next

Pending Approval

When a provider record requires additional approval, a "Pending Approval" indicator will appear on the provider enrollment screen (see screenshots below). This means a verification request has been initiated. Any user who is authorized on behalf of the provider, should click the "Call Now" button (e.g. ) to force the validation call.

The approval request is sent to the provider’s registered contact in the NPPES database. It is important to ensure that this contact information is up-to-date and that someone is available to respond. If the approval is confirmed, the enrollment process will continue, and the necessary documents will be processed and submitted. Until the approval is received, the enrollment will remain in a pending state.

If the group NPI shares the same tax ID with the rendering providers, completing the group’s approval first will automatically approve all associated rendering providers. If NPIs have different tax IDs, each will still require its own separate approval.

Users can still proceed with completing and submitting all enrollments even while the "Pending Approval" marker is on the account. However, the enrollment documents will not be submitted from our system until that approval is received.
PHONE SYSTEM WARNING
If your phone system uses a call tree, the validation call will not make it through. In this case, please call support at 855-757-6060 x2 and they will manually walk you through the phone confirmation.

Pending Approval Indicator

Phone Verification Call

New Provider Validation Features

Some new buttons are available on the Edit Provider screen to validate via phone:

  • Refresh Icon: This feature queries NPPES for an updated phone number in real time.
  • Call Now Button: Allows the authorized user to request an immediate phone call instead of waiting for the next automated attempt.