Enrollment is a process that lets your Payers know that you will be submitting electronic Claims (EDIs) and receive ERA's through our Clearinghouse partner, Change Healthcare. It is important to note that Enrollment is NOT the same as getting credentialed with a Payer.
After you have created your initial enrollment you can add additional enrollments to ensure any new payers and/or new providers can be billable on claims.
This is a great article to bookmark for reference as you work through the Enrollment Process.
Jump to Section [Step 1: Enroll Payers] [Step 2: Process Enrollments] [Step 3: Payer Approved] [Add Additional Enrollments]
Before you begin, ensure that you have done the following:
- Check the NPPES NPI Registry to ensure you are entering the correct NPI and Provider Information.
- Gather all information needed for the Enrollment Process.
- Check if your Payers require Enrollment
IMPORTANT: If Payer does not require enrollment, you can immediately begin submitting Claims to them.
Step 1: Enroll Payers with Change Healthcare
To submit Claims in WebABA using Change Healthcare (CHC) as your Clearinghouse, you will need to enroll your Payers.
- Click Organization in primary navigation bar.
- Click Claims Service in side menu.
- The Practice and Contact Information will default for you.
- Select NPI Type, either Individual or Group.
- Search for desired Payer.
- Enter all Providers with the NPI Type that you would like to enroll with that Payer.
- Click Add Additional Payer button and repeat the process to add more Payer Enrollments.
- OR click Submit when complete.
NOTE: If you want to submit the form to turn on Claims Service without submitting a Payer/Provider, select the checkbox on the lower left of the screen under NPI Type which reads:
I do not have any payer/provider enrollments to submit at this time. Please create my account with Change Healthcare and turn on Claims Service.
Step 2: Process your Enrollments with Change Healthcare
A Change Healthcare Rep will reach out to you within 5 business days of your Enrollment and will then work with you to complete your Enrollments with each Payer. They will also help navigate any rejections.
Your Enrollments will be delayed if you do not respond when your Change Healthcare Rep contacts you for additional Enrollment information. Change Healthcare will continue to reach out to you on a weekly basis for 30 days before giving you a deadline to complete the Forms. They will attempt to contact you on different days/times and may even reach out to CHC for an additional contact if necessary.
If you fail to provide the information needed by the deadline, the Enrollment project will be closed. The project will remain closed until YOU contact Change Healthcare to reopen it.
Step 3: Payer Approved
AGAIN - If your Payer did not require Claims enrollment - note add
After the Enrollment has been processed and your Enrollment is verified as Approved, you can begin billing to those Payers in WebABA.
Add Additional Enrollments
After you have created your initial enrollment you can add additional enrollments so that I can ensure any new payers and/or new providers can be billable on claims.
- Click Organization in primary navigation bar.
- Click Claims Service in side menu.
- Click Add Additional Enrollments.
- Select NPI Type, either Individual or Group.
- Search for desired Payer.
- Enter all Providers with the NPI Type that you would like to enroll with that Payer.
- Click Add Additional Payer button and repeat the process to add more Payer Enrollments.
- OR click Submit when complete.