Get Metro Plus Health Plan (13265) Era Enrollment ... - My Clients Plus

Filling out the Metro Plus Health Plan (13265) Era Enrollment form is an essential step in ensuring your practice receives electronic remittance advice. This guide provides clear and comprehensive instructions for completing the form online.

Follow the steps to complete your enrollment form accurately.

1. Click ‘Get Form’ button to obtain the Metro Plus Health Plan (13265) Era Enrollment form and open it in your preferred document editor.
2. Enter the payer information in the designated fields. Make sure to specify 'Metro Plus Health Plan' and include the payer ID '13265'.
3. Provide the provider's information by entering the provider's name and address accurately in the designated sections.
4. Fill out the provider identifiers section, including the Federal Tax Identification Number (TIN) or Employer Identification Number (EIN) and the National Provider Identifier (NPI).
5. Complete the provider contact information by entering the contact name, telephone number, and email address.
6. Select your preference for aggregation of remittance data in the electronic remittance advice section. It is crucial that this matches your preference for electronic fund transfer (EFT) payments.
7. Indicate the reason for submission, which will be 'New ERA Enrollment'.
8. Sign the form electronically by typing the name of the authorized individual who is submitting the ERA enrollment.
9. Review all entries for accuracy and completeness, as every field is required to avoid processing delays.
10. Save the completed form and email it to the appropriate address: support@officeally.com, ensuring the subject line reads 'Emdeon ERA Enrollment'.

Complete your enrollment documents online today to ensure a smooth processing experience.