Claims / Clearinghouses Change Healthcare – The Ins and Outs

Benefits of Setting up a Clearinghouse

There are two main benefits when connecting a CentralReach account to a clearinghouse. First, users can send out claims electronically within CentralReach. No need to do this on third-party websites or portals. Second, users can receive payments, in the form of an ERA (electronic remittance advice), directly in their CentralReach account. Users can then view, observe, notate, reconcile and ultimately post payments.

With our clearinghouse partner, Change Healthcare, users have two additional tools to support billing success. Users can electronically verify eligibility, in which they check that a client’s insurance is valid and receive information back from the payor regarding covered services. Users can also complete live claim status checks to find out what is happening with their claim. No need to spend time on the phone with payors, or to do this on payor websites.

Connecting CentralReach to Change Healthcare

To get started please contact your CentralReach account manager and subscribe to Change Healthcare. CentralReach will set up your SFTP gateway in the platform (to send claims and receive ERAs) and will set up your Change Healthcare ConnectCenter portal.

Click here to learn how to enroll payors on Change Healthcare.
Click here to learn how to add users to Change Healthcare.
Click here to learn more about Change Healthcare support.
Click here for the “Change Healthcare In’s and Out’s” course.

Claims / Clearinghouses Change Healthcare Checklist

When enrolling with Change Healthcare, the following needs to be completed:

  1. After receiving credentials, users should verify that they can log in. For issues logging in, contact support.
  2. A CPIDD # needs to be entered in CR for every payor.
  3. Users need to have a Member ID
    • Please note, certain special characters, symbols, and spaces are not allowed.
  4. When using generic contacts, the following information needs to be completed in CR:
    • Company name
    • Email address
    • Tax ID
    • NPI number
    • Contact Name
    • Phone number AND extension (if none, please enter “1”)
    • Address
    • Zip code

Claims / Clearinghouses Checking Client Eligibility on Change Healthcare

CentralReach users can check client eligibility / insurance verification on the Change Healthcare portal, ConnectCenter. Please log in to the ConnectCenter and click Verification > New Eligibility Requests.  

For step-by-step instructions on the five steps to client eligibility, log in to the ConnectCenter and read the help article here. Please note, Eligibility response data can be viewed and copied in either a human readable or 271 format. Also, eligibility responses can be stored and saved for up to 6 months.