EDI Request Reference Guide

This document outlines the requirements and expectations for our RevEquip and RevServe Members. All requests should be sent by Members to edi.help@webpt.com.

The targeted resolution time for most requests is 3 business days, however, if your request exceeds our targeted timeframe, you will receive a notification.

Below are the necessary details required for each request type. Failure to provide all requested information will delay the targeted resolution timeframes.

Details Needed	Targeted Resolution
Add New Providers
Please include in the request: Provider Name License # NPI # Locations in which provider will be treating patients	Within 3 business days
Provider/Location Credentialing
Please include in the request: Name of Payer Any specific legacy ID’s assigned during credentialing The location(s) for which the credentialing update applies Names of any individual providers who have been credentialed	Within 3 business days
New Locations/Location Changes
Please include in the request: Effective Date Location address, phone/fax numbers Contact for Location (if applicable) NPI/TIN for the location Any completed credentialing under the new physical location	Within 3 business days
Remove Claim Delay
Please include in the request: Provider and location(s) for which delay should be removed Claim delay that is being referenced, i.e., Medicare, pending credentialing, etc.	Within 3 business days
Missing ERAs
Please include in the request: Name of Payer Check number, check date, and dollar amount of the "missing" EOB *Per Optum, if the payer is under the Optum umbrella, the actual EOB is required as well	Varies as these may require the involvement of a third party such as a clearinghouse, however, WebPT will provide a status update every 2 business days
Claims Research/Formatting
Please include in the request: Payer for which the format change or claims research is being requested Account numbers and dates of service affected Any information that has been obtained by contacting the payer directly Details of request for claim (if applicable)	Varies as these may require the involvement of a third party such as a clearinghouse, however, WebPT will provide a status update every 2 business days
EDI/ERA Enrollments
Please include in the request: Payer for which the enrollment is being requested NPI number(s) if multiple numbers exist	Varies by payer. WebPT will follow up with payers every 10 business days until approval is received