Skip to main content

Documentation Index

Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt

Use this file to discover all available pages before exploring further.

Status: ✅ Complete Spec Reference: specs/pm/specs/PM-46-payer-enrollment-edi-onboarding.md
Last Updated: 2026-04-08

​
Integration Overview

PM-46 tracks EDI enrollment lifecycle per payer, per NPI, per transaction type. It integrates with several PM-internal specs and PF platform layers.

​
Platform Foundation Dependencies

PF SpecIntegration TypeWhat PM-46 Consumes
PF-01 (Organizations & Sites)Direct dependencyorganization_id, site_id scoping
PF-02 (RBAC)Direct dependencyRole-based access control
PF-10 (Notifications)Platform Integration LayerAlert delivery for stalled enrollments, credentialing prompts
PF-30 (Permissions)Direct dependencyPermission key enforcement (pm.edi-enrollment.*)

​
Internal PM Dependencies

​
PM-17 → PM-46: Credentialing-to-Enrollment Event

Pattern: Platform Event (Pattern 2)
Status: 📝 Planned Event: pm.credentialing.completed
Publisher: PM-17 (Provider Credentialing)
Subscriber: PM-46 (EDI Onboarding) Purpose: When PM-17 marks a provider as credentialed with a payer, PM-46 receives a notification to prompt EDI enrollment initiation. Payload (planned): 
{
  "organization_id": "uuid",
  "provider_enrollment_id": "uuid",
  "provider_id": "uuid",
  "payer_id": "uuid",
  "npi": "string",
  "credentialing_effective_date": "date",
  "event_type": "pm.credentialing.completed"
}
Subscriber action: Create task/notification prompting user to initiate EDI enrollment; optionally pre-populate enrollment record stubs.

​
PM-15: Clearinghouse Reference

Pattern: Data reference (FK)
Status: 📝 Planned PM-46’s pm_payer_edi_enrollments.clearinghouse_id references pm_clearinghouse_config.id from PM-15. PM-46 tracks the enrollment application lifecycle; PM-15’s pm_payer_enrollments tracks submission-readiness status. These are complementary, not competing.

​
PM-27: NPI & Site Data

Pattern: Data reference (read)
Status: 📝 Planned PM-46 reads NPI and site data from PM-27’s pm_site_billing_config to populate the enrollment matrix. No write dependency.

​
PM-07: Payer Reference

Pattern: Data reference (FK)
Status: 📝 Planned PM-46’s payer_id references the shared pm_payers table (also used by PM-07, PM-08, PM-15).

​
PM-08: Remittance Volume Data

Pattern: Data read (query)
Status: 📝 Planned PM-46 FR-4.1 (ERA gap report) queries PM-08 claims data for estimated monthly remittance volume per payer. Fallback is manual priority score when PM-08 data is insufficient.

​
Scheduled Processing

JobScheduleEdge FunctionPurpose
pm-edi-enrollment-stall-check0 8 * * * (daily 8 AM)/supabase/functions/pm-edi-enrollment-stall-checkDetect stalled enrollments, create PF-10 notifications

​
Validation Checklist

  • Event contract for pm.credentialing.completed added to EVENT_CONTRACTS.md
  • FK relationships validated against PM-15, PM-17, PM-27 schemas
  • PF-10 notification types registered for stalled enrollment alerts
  • Permission keys seeded in migration
  • Cross-core integration matrix updated
Last Updated: 2026-04-08