Provider Validation Required
- Provider Validation (Phone Verification via NPPES)
After you add a new provider in the Provider Enrollment screen, Claim.MD may require Provider Validation to confirm you are authorized to exchange data for the provider’s NPI. - Why this is required
To verify authorization, Claim.MD places a phone call to an official phone number listed for the NPI in the NPPES database. - When you will see this
If the provider record shows “Pending Validation Step”, validation is required before the provider can be fully set up to send and receive transactions, such as Claims, ERA, or Eligibility.
The provider validation step is completed on the payer enrollment page. If validation is required, the Provider Validation screen displays when a Quick Enroll or Enrollment Required button is pressed. - How to complete Provider Validation
- Start an enrollment for any payer or transaction you need, such as Claims, ERA, or Eligibility.
- The system will display the phone numbers on file in NPPES for that NPI.
- Select a number, then click “Call Now”.
- Our AI agent immediately places an on-demand call, the recipient answers, and confirms approval for setting up the provider record in Claim.MD.
- If no one is reachable at the listed numbers
If the provider cannot be reached at any phone number listed in NPPES, you have two options:- Work with a provider representative who can answer at one of the listed numbers, so they know to expect the call and approve it.
- Update the provider’s public contact phone numbers in NPPES, then retry validation.
NPPES: https://npiregistry.cms.hhs.gov/search
ERA Delivery Options After Validation
ERA Delivery Options After Validation
After completing validation for the first time, providers may see a prompt if another account already has active ERA enrollments for the same NPI/Tax ID. This allows providers to choose whether future ERA should route to the newly validated account.
If ERA is redirected, any existing provider records with active ERA enrollments will move to a Pending Validation status until validation is completed again on those records.
After completing validation, if another account has active ERA enrollments, you will will see this prompt:
