IMPORTANT: If you enrolled your Payers before 5/1/21, your Enrollments will be processed with Madaket. You will complete the process with Madaket, but any new Enrollments going forward will be completed with Change Healthcare. Click here to see the Madaket process.
What is Change Healthcare?
Apex has partnered 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!
Your Change Healthcare Rep will contact you with in 2 business days of your Enrollment. If an Insurance Company requires additional Enrollment forms or information, they will work with you to gather that and submit it to the appropriate. Change Healthcare will keep you up to with a weekly Payer Enrollment Status Update email.
Change Healthcare Enrollments FAQs
NOTE: These FAQs are pulled from the Change Healthcare FAQ document, placed here for easy reference.
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.