Payer & Payer Agreement FAQs

What's the typical turnaround time for an agreement to be approved?

The turn-around time is dependent on the payer. It can take anywhere from 1 - 60 days to be approved. You can find the "Estimated Approval Time" for the payer your completing the agreement for on the cover-sheet of the agreement (On agreements with multiple CPID’s this will not populate until you select a CPID) or while under searching for new agreements, it isdisplayed under the "Estimated Approval Time (days)" column. 

Unfortunately, all payers work on the agreements as they receive them. They do not expedite them for us. You may be able to contact the payer yourself and request for them to expedite the approval.

What if I receive an approval directly from the Payer?

Forward the approval to CollaborateMD support <>. We’ll provide your agreement to the clearinghouse.

Do I send my payer agreements to Change Healthcare or to the payer?

Your payer agreement should be sent according to the Special Instructions on the cover sheet for each agreement. In most instances the agreement can be sent to the Clearinghouse (Change Healthcare) and they will forward to the appropriate party.

Is there a document to help me complete payer agreements?

Our Payer Agreement Help Article provides you with step-by-step instructions on how to fill out a payer agreement. If you require additional assistance please contact the Payer.

Can we use our own clearinghouse instead of Change Healthcare?

At this time, CollaborateMD has an exclusive partnership with Change Healthcare. The benefits of our exclusive partnership are that we have integrated solutions and edits in the system that will increase your first-time acceptance rates by analyzing claims before they get sent out.

 "Is the Provider a Direct Submitter Customer?"

A Direct Submitter Customer would be someone who submits directly to the clearinghouse without going through a software vendor. For all CollaborateMD customers, the answer to this question would always be "No."

Do I need to complete an agreement for every provider or facility?

Agreements are completed on a Tax ID level, meaning if you bill with multiple tax id numbers for that provider each provider would need an agreement to be filled out. If you only have one tax id number, then only one agreement is needed. 

We recommend contacting your payer to determine how you should complete your payer agreement, as some payers in some states may require you to fill out an agreement for every NPI you have.

When does a new payer agreement need to be completed?

When a TaxID or NPI has been updated with the payer, the provider should complete a new payer agreement. Providers will need to confirm directly with the Payer when the change is made with them if new enrollments are required.

I have 2+ payers with the same CPID; do I have to fill out an agreement for each of them?

No. Agreements are per unique CPID,you will only have to fill out one agreement for the one CPID.

If a payer does not require an agreement, what is my next step?

There is no additional action required. Because there is no agreement required, you can begin submitting transactions to the Payer using the appropriate electronic CPID or Payer ID depending on the transaction type.

How can I receive payer notifications from the clearinghouse?

If you wish to receive email notifications from Change Healthcare such as payer processing & Change Healthcare issues/updates, product and industry news, and payer enrollments, you can update your submitter profiles email address and enable these

You are only allowed to make changes that you are authorized for based on your assigned roles. Follow the steps below to update your submitter profiles email address and enable these notifications.

  1. Log into ConnectCenter.

  2. Click the My Settings button.

  3. Under Current Selected Products, select the products you wish to receive email communications and alerts from Change Healthcare. 

  4. Click on the Update User button. 

  5. Next, a confirmation message will display confirming your changes.

When I select an agreement, why does the status say "Under Construction"?

The agreement is currently not available for completion within the CollaborateMD application because its being revised by Change Healthcare. Once Change Healthcare completes the agreement it will be available within CMD

Why am I unable to locate the agreement for my payer?

There are multiple reasons why an agreement may not be found:

  1. The payer has not been added to the local list. You can either add the payer to your list or check the box to Show products for all payers within the filter. 

  2. The payer may not require an agreement. You can view this within the Clearinghouse Information box within the payer. When required, "Agreement Required" will be listed for each electronic service available for the payer.

  3. If the agreement has already been completed for the same submitter number before, it will be hidden from view. In order to see this agreement again, select the Include completed agreements checkbox.

  4. If you are getting the “There was a problem with your request. Please check your credentials and try again.” message. To correct this Click the "Edit" button, then enter the correct username and password. Your Username consists of your Submitter # followed by xgear (e.g. 123456xgear). You can locate your submitter # within the Provider section of the application.

Should I complete the claims agreement prior to the remittance agreement?

It depends on the payer. Many payers are now combining these agreements so that only one agreement is required. Please review the cover sheet of the Claims/Remittance agreement for more information.

Do all Payers send acceptance messages back?

No. Not all payers send messages back within the Claim Tracker. This is why you want to be sure to always check your Payer Generated reports and follow up with those payers if you haven't received a message from them.

How long does it take before I receive a response message back from payers?

Typically about two (2) days after the submission of the claims and acceptance from the Clearinghouse.