Provider Information Page - in 2025

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In the most basic terms, provider enrollment (sometimes referred to as payer enrollment) is the process through which healthcare providers apply to be included in a health insurance network. As an in-network provider, you will be able to treat patients who carry that insurance and be reimbursed for your services.
The Provider Information Return (PIR) is an annual submission that requires information about your service, any changes made, and how you ensure its Safe, Effective, Caring, Responsive, and Well-Led.
Provider enrollment is distinct from credentialing, although the two processes are often interrelated. While credentialing focuses on verifying the qualifications and competence of the provider, enrollment is about establishing the providers eligibility to bill a particular payer.
An Enrollment ID is a 15-digit unique alphanumeric identifier that is assigned to each new provider enrollment application. All enrollment-level information (e.g., enrollment type, enrollment state, provider specialty and reassignment of benefits) is linked through the Enrollment ID.
Why Is Provider Enrollment Important? Provider enrollment allows providers to join the insurance plans accepted by their healthcare organization or practice. Its also a legal requirement. Most insurance companies and government payers, like Medicare, require providers to be enrolled before they can submit claims.
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Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels.
The PIN is the secret code that is used as validation of an enrolled providers identity whenever the provider needs to access and transmit information to and from the Medi-Cal program. A Submitter ID is an additional identifier number used specifically for the electronic claims submission process.

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