Triwest has changed their clearing house information, so for those that are enrolled in paperless billing (meaning you receive electronic EOBs - explanation of benefits, ERAs - automatic deposits, etc.) you will need to follow the steps below.
They are asking everyone to re-enroll with the new clearing house.
Additionally, if you are interested in enrolling in EFTs/ERAs for the first time, you can also follow these steps. Questions regarding EFTs, ERAs, EOBs, etc. are all answered on the attached form.
PLEASE NOTE: If you want to continue with paper correspondence for billing you can disregard this email and these steps.
Additionally, if you are waiting for your Triwest credentialing to process, please know that you are not alone and we are getting daily updates on all of you. As soon as we know that you are through, we will reach out.
Here is how you will enroll:
Step 1: Fill out the attached application for ERAs and EFTs (or only EFTs if you want funds only - again, these are all explained in detail in the attached document)
The form will include mostly your personal information as an Independent Provider. The information that you will need to include that involves Help Therapy is the Clearing House information which allows us which allows us to receive your ERAs electronically.
Electronic Remittance Advice (ERA). There will be two sections where you will include Help Therapy's billing information:
Section 1 is on Page 1 and the information should be as follows:
Information under trading partner ID should be 7GW1471MO3, not 99032 as shown above.
The second section is on page 2 and should include the following information:
The information for the above section will be as follows:
Clearinghouse Name: Trizetto Provider Solutions, LLC
Telephone Number: 800-969-3666
Email Address: PEApprovals_TPS@Cognizant.com
For the reason for submitting, you will check New Enrollment if you have not done ERAs in the past or Transition enrollment if you have.
Step 2: Once you have completed these forms, you will send them in to TWO different places if you are faxing and one place if you are mailing - we recommend faxing in so the change can take place more quickly.
Important: For EFT Enrollment, a copy of front & back of the provider's voided check is needed to be sent along with the Enrollment form. Also, on page 2 don't forget to put at least 2 recent check #s received within the last 30 days from payment dates. And the submitter signature should be written, otherwise they will not process the enrollment request.
Note: EFT is not required or necessary to enroll with ERA, but the providers have the option to enroll with EFT as well if they want to. The provider can enroll with either EFT or ERA or both.
In case we enrolled them to ERA, ask the providers in follow up email if they need to do EFT as well.
1. ERA Form (Electronic Remittance Advice Form):
- Fax this form to PGBA at 803-264-9864
OR
- Mail to
PGBA, LLC
PO Box 108853
Florence, SC 29502-8853
2. EFT Form (Electronic Funds Transfer):
- Fax it to PGBA at 803-419-3233
OR
- Mail to
PGBA, LLC
PO Box 108853
Florence, SC 29502-8853
*If you are mailing both forms, they can both be mailed to the address above.
If you have any questions, please feel free to email me back here.