What is Change Healthcare?
Apex is now partnering with Change Healthcare to help process Enrollments. This is great news for you!
Not only does Change Healthcare help to fill out the Enrollment Forms, and manage the Enrollment process, they have also formed partnerships with Insurance Companies that allow us to process your Enrollments more quickly!
Once you have submitted the Enrollment Survey to Apex you will receive a call from your Change Healthcare specialist and they will walk you through all.
- You will get a call from Change Healthcare within 2 business days of enrollment to gather any additional information needed for you EDI/ERA Enrollment - e.g. Tax ID, Billing NPI, Payers, etc.
- Your Change Healthcare Rep will then submit your enrollment forms to your Payers.
- IF a Payer requires the Provider or Agency to directly submit enrollment via a portal, your Change Healthcare Rep will walk you through the process.
- You Change Healthcare Rep will serve as a consistent contact point through the process and will provide weekly Enrollment Status updates.
- Contact your Change Healthcare Rep for any questions regarding your EDI/ERA enrollments.
- Change Healthcare will work with the you and the Payer to resolve enrollment 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 Apex 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.
Apex/Change Healthcare Switch FAQs
Apex Clearinghouse will switch to Change Healthcare as of May 1, 2021. All EDI/ERA Enrollments submitted on or after May 1 will be processed through Change Healthcare.
How does this affect me?
|I've Never Completed
Enrollments with Apex
|I have Enrollments
In-Progress with Madaket
|I Already Completed My Enrollments with Madaket|
How do I submit NEW EDI/ERA Enrollments going forward?
- The Enrollment Process still starts in TheraNest just like you did before they will just be processed by Change Healthcare.
Will I need to re-enroll Payers with Change Healthcare if they were already enrolled with Madaket?
- Nope! There is no need to re-enroll Payers. Any Payers that have already been approved and setup in TheraNest are good to go.
I originally enrolled with Madaket, what do I do if I need to enroll a new Payer?
I have Enrollments In-Progress with Madaket
|I already completed my Enrollments with Madaket but need to add a New Payer|
Change Healthcare Enrollments FAQs
Once you have started Payer Enrollments with Change Healthcare these FAQs will any answer questions about the process with Change Healthcare.
Enrollments are done in batches/projects. Any Enrollments done in the same time frame will be processed as one project with Change Healthcare. A project has a 60 day window to be completed from the day it was initiated.
How will my Change Healthcare Rep contact me?
- If this is your first Enrollment ever with Change Healthcare you will receive a call within 2 business days from your Change Healthcare Rep.
- If you have completed Enrollments before with Change Healthcare and are adding another Payer Enrollment you will receive an email in 2 business days from your Change Healthcare Rep.
I have Enrollments in-progress with Change Healthcare but need to add another Payer Enrollment, how do I do that?
- If it is within that initial 60 day window for an in-progress Enrollment with Change Healthcare and you need to add a Payer Enrollment for the same Location, NPI, and TIN, contact your Change Healthcare Rep and they will add it to you existing project.
- If it is outside of that initial 60 day window and you need to add a Payer Enrollment for the same Location, NPI, and TIN, you will start a new Enrollment (which will start a new Change Healthcare project) from TheraNest. Change Healthcare will contact you within 2 business days to help complete those Enrollments.
- If you need to enroll a Payer for a different NPI or TIN you will need to submit a new Payer Enrollment Survey through TheraNest with that NPI or TIN. Change Healthcare will contact you within 2 business days to help complete those Enrollments.
NOTE: If you attempt to add Enrollments to an open project with a different NPI or TIN, Change Healthcare will refer the you back to Apex.
I have already completed Enrollments with Change Healthcare but now need to add another Payer Enrollment, how do I do that?
If you need to add another Payer after you already completed some Enrollments with Change Healthcare you will start any new Enrollments from your TheraNest account. This will start a new project with Change Healthcare and a Change Healthcare Rep will contact you within 2 business days to help complete your Enrollment.
How will I know when my Payer Enrollments have been approved?
You will receive a weekly status update email from Change Healthcare. Use this email to verify that your Payer has been approved.
Why do I have multiple Change Healthcare Reps?
Change Healthcare does their best to assign the same Change Healthcare Rep to work with your Enrollment Contact. If you are working with multiple Change Healthcare Reps over multiple open Enrollment projects, you can request that the project be 'reassigned' to the same Rep. You can work with your Rep to customize how they would like the Enrollment grouped, either as one with multiple tabs or separate emails.
I received an approval or rejection directly from the Payer, now what?
While Change Healthcare will do everything they can to make sure that they receive the notice, there may be an instance where you receive an approval or rejection notice directly from the Payer. In this case, be sure to contact your Change Healthcare Rep to let them know.
I have a question about my in-progress Enrollments, who do I contact?
When you Enroll Payers with Change Healthcare you should receive a welcome packet with an email address for your Change Healthcare Rep. Feel free to reach out to your Rep concerning any in-progress Enrollments questions or concerns.
If you reach out to TheraNest or to Apex, we will direct you back to you Change Healthcare Rep.