Medical & Hospital Claims Enrollment Forms

Change Healthcare has developed processes to allow payers and providers to electronically exchange sensitive medical claims, patient eligibility, ERA, and EFT payment information.

Each provider must be set up in the Change Healthcare system to submit claims. A provider can submit an enrollment form themselves, or instruct their vendor to use our self-service enrollment portal to link you to the payer(s). If your vendor does not have access to the self-service portal, please see our category table below.

Step One: Specific payers require additional EDI enrollment paperwork to be completed for submission of claims. Please check the Change Healthcare Payer List for each payers EDI Enrollment Requirements.
Step Two: If EDI paperwork is required by a payer, you must receive an approval from the payer prior to submitting claims. Claims submitted without prior approval will be rejected.

***NOTE: If hard-copy forms are submitted by a vendor that has on-line access to the Change Healthcare portal, the hard-copy forms will be rejected.