New Agreement

Some payer agreements may not be available for completion via the CMD application. In the event an agreement cannot be filled out for a particular payer, it needs to be filled out directly through the connect Center website. 

  1. Visit and enter your User ID & Password.

    Your ChangeHealthcare User ID consists of your Submitter # followed by xgear. You can locate your submitter # in the Provider section of the application. e.g., 123456xgear

Agreements MUST be filled out online before you print and mail them. Follow the steps below to fill out a new agreement through Enrollment Central.

  1. Visit ConnectCenter and log in with your credentials. 

  2. Click on Payer Tools > Select Enrollments > Go To Start New Enrollments.

  3. Click New Provider.

  4. Enter the NPI and click Validate.

  5. Click Next and search for the Payer(s) and products you wish to do an enrollment(s) for.

  6. Click on the Agreement you wish to fill out and drag it to the Selected Payers list on the right-hand side. 

  7. After all products are selected, click Next.

  8. Review the  special instructions on the agreement, which are organized by the payer, then select Next.

  9. Answer the general and payer specific questions, then click Next.

  10. To review the forms before submitting, click the PDF icon next to the agreement you want to review.

    Do not print this version of the form. This is a draft of the agreement.

  11. Once the agreements have been reviewed, click Complete.

  12. If any forms need to be mailed to Change Healthcare, a new window will pop up.

    1. Click Generate Forms and select the Print icon.

    2. Click Done.

  13. Once the form(s) has been completed, you may be required to print the agreement and mail / fax it to Change Healthcare.

    Reference the instructions on the cover sheet of the agreement for further instructions on how to submit the agreement to Change Healthcare.