ERA Enrollment Form

80.4 - ERA Enrollment Form (Rev. 3288, Issued: 07-02-15, Effective: 08-03-15, Implementation: 08-03-15) The CAQH CORE mandated operating rules establish standards for the enrollment of providers to ERA programs. The rule mandates the required data elements and the order in which they appear on the ERA enrollment forms. The rule also mandates acceptable EFT enrollment submission formats. A complete list of required data elements and submission formats are available at http://www.caqh.org/Host/CORE/EFT-ERA/ERA_Enrollment_Data_Rule.pdf