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“Setting up a payer” is really four separate jobs. They loosely happen in this order the first time, but you’ll revisit each one independently for the life of the practice, new payer, new provider, new bank account.

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Get contracted and credentialed

Before a payer will pay you at all, you need a participation contract and a completed credentialing file (NPI, CAQH, and for Medicare, PECOS). This is the long pole, 90 to 180 days per payer, so it starts first and everything else proceeds while you wait. Full walkthrough: Get credentialed.

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Register in the payer’s portal

Almost every payer delegates provider self-service, eligibility, claims, payments, to a portal. A few run their own (Cigna, HAP); most share one (Availity, EnrollSafe, Optum Pay, PaySpan). You register once per portal, then manage every payer inside it. Find which portal each of your payers uses in the payer enrollment directory.

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Enroll in EFT and ERA

EFT gets you paid by direct deposit instead of paper checks; ERA gets you the electronic remittance (the 835) that explains each payment. They are separate enrollments in many portals, it’s possible to get paid electronically while remittances still arrive on paper, which makes reconciliation miserable. Enroll in both, everywhere. General playbook (including payers we don’t list): Enroll in EFT and ERA. Exact clicks for each payer: the directory.

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Keep the bank details current

Each enrollment names a specific deposit account, and payers don’t share bank changes with each other, even inside the same portal. Any account change means updating every payer individually, sequenced so deposits never stop: Switch banks without missing a payer deposit.

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The directory

Payer enrollment directory

88 payers, 13 portals, enrollment, updates, and bank changes for each.

Enroll in EFT and ERA

The general playbook, for payers not yet in the directory.

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The traps

Enrollment level. Some portals enroll at the TIN level (Availity, every NPI under the tax ID at once), others at the NPI level (ECHO lets you choose). Mixing them up is the most common reason one provider in a group gets paper checks while the others get EFT. Verification lag. Payers verify bank accounts with test deposits (PaySpan, HAP) or prenotes (TMHP), the enrollment isn’t live until you’ve confirmed them. ERA routing. Your clearinghouse choice determines where 835s land; changing clearinghouses means re-pointing ERA enrollment payer by payer.