Smart Data Stream Provider Portal

The Smart Data Stream Provider Portal gives you immediate, simple, and free access to submit and track claims directly through your web browser. You can either key the claims individually through our Direct Data Entry (DDE) modules or submit a batch of claims through EDI. Smart Data Solutions will also scrub the claims to check for any errors that may cause your claims to get rejected by the Payer. Additional features of our portal include: professional, dental, or facility claims submission, eligibility checking, claim status tracking, electronic remittance advice (ERAs), provider registration, and dashboard volume views.
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Affiliations and Partnerships

Smart Data Stream processes over 500M transactions annually.

Transaction Type

Claims

There are two options to submit a claim through the Smart Data Stream Provider Portal. You can either upload a claim file or you can do Direct Data Entry (DDE) and key in a new claim. When uploading, you have the ability to upload claims in batches to the portal. As long as it’s a valid 837 file and has a payer ID in the REF02 segment, SDS will successfully route your claims to the Payer. With DDE, you can choose a Professional/CMS150, Institutional/UB04, or Dental claim form. Once the claim type has been selected, it will bring up a template for the claim information to be typed into.

Transaction Type

ERA Routing

To set up ERA routing, you will have to fill out the enrollment form with the following:

  • Provider First Name
  • Provider Last Name
  • Provider Email
  • Provider TIN (required)
  • Provider NPI
  • Provider Address
  • Provider City
  • Provider State
  • Provider Zip

You will have the option to select the Payers and Trading Partner that you would like to have ERAs sent to. Once you’ve set these options, sign and submit your application.

Note: For the effective date, the soonest date available will be three days after the submission date. Any payments you receive after that submission date will have a corresponding ERA sent to your account.

Transaction Type

Eligibility

To do an eligibility inquiry, you will have to add the Payer to your eligible Payers.

  1. Go to the Eligibility tab and select “update Payers”.
  2. Then select the Payers you would like to check eligibility for and save.
  3. Now, you will be able to run the inquiry.

 

Transaction Type

Claim Status

To do a claim status inquiry, you will have to add the Payer to your claim status Payers.

  1. Go to the Claim Status tab and select “update Payers”.
  2. Then select the Payers you would like to check claim status for and save.
  3. Now, you will be able to run the inquiry.

Transaction Type

27x Submission and Enrollment

Smart Data Stream’s Provider Portal allows for easy access to connected Payers’ real-time information systems. Our portal has claim status and eligibility interfaces that allow you to get the information they need on-demand without calling in requests. This information is in a clean and straightforward display. The back-end connections fulfill the requests over the CAQH CORE 270/271 and 276/277 protocols, maintaining compliance with the real-time information request mandates.

Transaction Type

Claims

There are two options to submit a claim through the Smart Data Stream Provider Portal. You can either upload a claim file or you can do Direct Data Entry (DDE) and key in a new claim. When uploading, you have the ability to upload claims in batches to the portal. As long as it’s a valid 837 file and has a payer ID in the REF02 segment, SDS will successfully route your claims to the Payer. With DDE, you can choose a Professional/CMS150, Institutional/UB04, or Dental claim form. Once the claim type has been selected, it will bring up a template for the claim information to be typed into.

Transaction Type

ERA Routing

To set up ERA routing, you will have to fill out the enrollment form with the following:

  • Provider First Name
  • Provider Last Name
  • Provider Email
  • Provider TIN (required)
  • Provider NPI
  • Provider Address
  • Provider City
  • Provider State
  • Provider Zip

You will have the option to select the Payers and Trading Partner that you would like to have ERAs sent to. Once you’ve set these options, sign and submit your application.

Note: For the effective date, the soonest date available will be three days after the submission date. Any payments you receive after that submission date will have a corresponding ERA sent to your account.

Transaction Type

Eligibility

To do an eligibility inquiry, you will have to add the Payer to your eligible Payers.

  1. Go to the Eligibility tab and select “update Payers”.
  2. Then select the Payers you would like to check eligibility for and save.
  3. Now, you will be able to run the inquiry.

 

Transaction Type

Claim Status

To do a claim status inquiry, you will have to add the Payer to your claim status Payers.

  1. Go to the Claim Status tab and select “update Payers”.
  2. Then select the Payers you would like to check claim status for and save.
  3. Now, you will be able to run the inquiry.

Transaction Type

27x Submission and Enrollment

Smart Data Stream’s Provider Portal allows for easy access to connected Payers’ real-time information systems. Our portal has claim status and eligibility interfaces that allow you to get the information they need on-demand without calling in requests. This information is in a clean and straightforward display. The back-end connections fulfill the requests over the CAQH CORE 270/271 and 276/277 protocols, maintaining compliance with the real-time information request mandates.

Resources

Smart Data Solutions integrates with Payers and Providers nationwide, offering a host of solutions to make clearinghouse connections easier.

Sign up for our Provider Portal
Provider Portal Companion Guide

Contact Information:

Additional Information:

  • Providers do not need an authentication token to log in.
9,200
Connections
500M
Transactions annually
200,000
Provider connections
Over $1Billion
in transaction billing per month

Frequently Asked Questions

Can I have more than one TIN/NPI account?

+
x

Yes. A single account can have any number of TIN/NPI combinations.

Do I need to complete the ERA enrollment to check eligibility/claim status?

+
x

No, the ERA enrollment is only if you'd like to receive ERAs. If your account is redirecting you to the ERA enrollment page when you first log in and you don't wish to sign up for ERAs, you may disregard this and go straight to the section you need using the top menu bar.

Why am I getting an error when trying to submit a New Claim/Eligibility Inquiry/Claim Status Inquiry?

+
x

The most common reason for a general error when trying to submit is that no payers have been selected yet. Confirm that the payer you want to connect with has been selected in the Update Payers section of that page.

Why am I getting an error when trying to update my existing ERA enrollment?

+
x

If all required fields of the ERA enrollment form are filled out, but you're still getting an error when submitting, check to make sure that there aren't any empty lines in the Payer Selection area. If there are any empty lines, click on the X to the right to remove it.

These empty lines are from Payers you were previously enrolled for, but who have since discontinued service.

I enrolled for ERAs, but I don't see anything in the account. Where can I find them?

+
x

The ERA enrollment is not retroactive and will only start receiving ERAs for payments issued at least three days after you enrolled. For any previous payments, you'll want to contact the payment vendor or insurance company directly. All ERAs will appear under the Remits tab.

Can I change my username?

+
x

Usernames cannot be changed, but if you'd like a different one you can create a new user for yourself. First use the +Add New User button on the Users page under Account Management. After you've created the user, click on Edit User and grant that user Admin Access.

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CLIENT TESTIMONY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
View Story
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CLIENT TESTIMONY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
View Story
icon

CLIENT TESTIMONY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
View Story

CLIENT TESTIMONY

Debbie Ziegler

Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
View Solution

CLIENT TESTIMONY

Brian Janssen

VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
View Solution

CLIENT TESTIMONY

Matthew Estes

Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
View Solution

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