Agreements for Claim Attachments

After creating your Attachment Payer, an agreement is required to send electronic attachment claims and receive remittances from attachment payers. The agreement will need to be filled out for the CPID number you are using for your Attachment Payer (5861 or 3657.) If you have multiple attachment payers only one agreement per CPID is required.

Please reference our New Payer Agreement Help Article for step-by-step instructions.

You will need the printed copy of the submitted agreement to register your account within the ChangeAssurance Attachments Portal.