What is Roster Submission

Roster Submission Definition

Roster Submission is the "Handshake" between the provider and the payer. For Payer Ops, this is the start of the data ingestion workflow. For C-level Executives, the "Submission Frequency" (Monthly, Weekly, or Daily) is a key indicator of network accuracy. Many state mandates now require that large groups submit their rosters at least monthly. Operationally, submissions must be handled via secure channels (SFTP) to protect the sensitive "PHI" and provider-specific data within the files. Strategically, organizations are moving toward "Validated Submissions," where the payer’s portal checks the file for errors at the moment of upload, giving the provider group instant feedback to fix mistakes before the file is even accepted.

FAQs

What is SFTP and why is it used for rosters?

Secure File Transfer Protocol; it is an encrypted way to move large files (like rosters) over the internet to ensure HIPAA compliance.

Can a provider submit a roster via a "PDF"?

No. Rosters must be in a "Machine-Readable" format (Excel, CSV, or JSON) so that the payer’s system can automatically ingest and process the data.

What happens if a submission is "Rejected"?

The payer sends a "rejection report" to the group detailing the errors (e.g., missing NPIs), and the group must fix the data and re-submit the entire file.