Is provider pre-enrollment required for eligibility requests submitted via the API?

Question:
Do providers need to be pre-enrolled in Claim.MD before submitting eligibility requests through the API?

Answer:
No. Providers no longer need to be pre-enrolled in Claim.MD in order to submit eligibility requests through the API.

With this API update, eligibility requests can be submitted by including the provider’s Tax ID. If a matching provider record does not already exist, Claim.MD will automatically create one as part of the eligibility request process.

This change is backward compatible with the previous workflow. Existing integrations that rely on pre-enrolled providers will continue to function as before, but manually enrolling every provider is no longer required for eligibility requests submitted via the API.