Payer Section

The Payer section provides the functionality to select from over 2000 payers to automate and manage claims and payer demographics. This section allows you to view, add, export, print or modify payer information; such as name, payer types, identification numbers and more.


The following help pages are supported by the current version of CollaborateMD. Please follow the curriculum outline to receive the proper training associated with this section.

Payer Information

Provider ID Numbers

Contracts

Options

Notes

Alerts

Agreements

Button Overview

Below you will find a description of the buttons located within the Payer section:
  • ConnectCenter: Selecting this option will take you to the ConnectCenter website where you will be able to fill out your payer agreements. 
  • CMS Form Version: Selecting this option will allow you to choose which CMS form you want to use for professional and institutional claims.

Please note that all payers do not require payer agreements to be filled out in order to process electronic claims. In the event, a payer does require an agreement to be filled out CollaborateMD provides two convenient methods that will allow you to fill out and search for payer agreements. Agreements can be filled out through the CollaborateMD application through our API or on the ConnectCenter website.

Overview

Payer Agreements

Payer also known as Electronic Data Interchange (EDI) agreements are forms that contain the legal agreement that addresses the electronic transactions that will occur between a payer and the practice or provider. Payer agreements required by specific payers must be approved by the payer before they accept electronic claims from your practice. Once the agreement is filled out and submitted to the payer for processing, you will be notified through CollaborateMD Messaging when the payer has approved or denied your agreement. Note: CollaborateMD has no control over the agreement processing time. Each agreement cover sheet will give you an estimate of how many days it will take to be approved, please use this as a reference. Once the agreement has been approved, and electronic transactions begin, the account becomes responsible for any additional fees associated with these transactions, if applicable. Please review the Accounting FAQs for further pricing information. 

Clearinghouse Process

Once your payer agreements are approved, you can begin submitting electronic claims to your payers. A clearinghouse is an organization that exchanges transactions and information between the billing entity and the insurance payers. CollaborateMD uses RelayHealth as our exclusive clearinghouse.

Submitter Number

A submitter number is unique per tax ID and is used in the completion of payer agreements and to send claims electronically. You can find your submitted number in the Provider section of the application. 

Turnaround Time by Payer 

Insurance

Min Days

Avg. Days

Median Days

Max Days

Medicare

3

11

5

60

Medicaid

3

12

14

50

BlueCross/BlueShield

3

12

12

40

TRICARE/CHAMPUS

1

16

12

30

Commercial/HMO

1

14

16.5

60

Worker’s Comp

3

6

12

30

Note:  Many Commercial Payers do not require enrollment 

Note: If RelayHealth has not received a response from the payer by the Estimated Approval Date, a RelayHealth representative will reach out to that payer within the same week requesting a status update. 

Getting Started

Completing electronic payer agreements is a quick and easy process. Here’s a list of items you need to be aware of or need to perform before proceeding: 
  • Be sure you have your ConnectCenter  User ID and Password. If you're a new customer and you haven't received your submitter number please contact your Training Specialist. Otherwise contact our Support Department for additional assistance. 
  • The ConnectCenter website may function differently with different browsers regarding the displays of new web pages in the same browser window or a new browser window may open to display the new page. However, the basic functionality of the website will be the same. The agreements are electronic forms that are viewed using Adobe Reader. 

NoteTo fill out agreement documents on-line, please ensure that most recent version of Adobe Reader is installed and configured for PDF display in the browser on all applicable PC’s.We strongly recommend using the most recent version of Adobe Reader is installed for optimal performance. It is also recommended agreements are completed using Internet Explorer

If you are using Adobe 10 (Adobe X) or a previous version, you will need to click on Add Host to Privileged Locations from the options on the bar at the top of the page.

  • An agreement must be completed for each unique submitter number. For example, if 3 providers are billing under the same submitter number only one agreement is required. If 3 providers are billing under 3 different tax id's, 3 agreements will have to be filled out.
  • If the provider is part of a group, then the group information is required. (i.e. Group Name, Group Tax ID, Group Provider Number, etc.
  • If payers require an agreement for each provider, it will be specified in the agreement either on the cover sheet or an additional page provided for the provider numbers.
  • If an agreement requires a signature, the agreement must be printed, signed by the provider, and either mailed or faxed to RelayHealth depending on the special instructions on the agreement cover sheet. All agreements requiring a signature must be signed in blue ink.

CollaborateMD API

Filling out agreements within CollaborateMD allows to you to submit agreements for multiple payers/products at once, eliminating redundant questions among the forms and drastically reducing time spent filling out new agreements. You can fill out payer agreements for three types of electronic products; Claims, Remittance, and Eligibility. 

Note:
Please be aware that not all payer agreements are available for completion via the CollaborateMD application. In the event an agreement cannot be filled out for a particular payer, it will indicate in the Status column “Available on 
ConnectCenter Only”. Please note that the list of payers will be updated frequently by RelayHealth and CollaborateMD.


warning.gif

Users will also need permissions to the Practice and Provider section in order to complete payer agreements. Click HERE to see how to edit user permissions.  

New Registration

Follow the instructions below to create a payer agreement through the CollaborateMD application: 

Part 1: 

  1. Go to the Payer section, click on the Agreements tab. 
  2. Click on the “Choose Provider” button to select the provider you wish to register. 
  3. When the Provider Search dialog window appears, select the provider of your choice. Note: The selected provider must have an assigned submitter number in order to continue. 
  4. Important: Once the provider is chosen, verify that the provider, NPI to use and submitter number selected is whom you wish to create the agreement for. Your ConnectCenter username will automatically be populated when you select a provider. 
  5. Enter your ConnectCenter password to continue. Note: If you have forgotten your password, you can click on the ‘Forgot your password? button.
  6. When you're done, click Next

Part 2: 

  1. Use the search filters to begin searching for the products you wish to create an agreement for. You can search by CPID, payer name, product, claim type or status. 
  2. In the Status field you can choose one of the three status: 
    • Active: Agreements that can be completed via the CollaborateMD application. 
    • Under Construction: Agreements that are listed as Under Construction are being updated by RelayHealth and are temporarily unavailable for completion. 
    • ConnectCenter: Agreements that are listed as ConnectCenter can only be completed via the ConnectCenter website.
  3. You can choose to select the “Include Completed Products” drop down menu to show agreements that have been completed and submitted to  RelayHealth. Note: These agreements will have a check mark in the Completed column. 
  4. Optional: By default, the payers displayed will only be the payers you've added to your personal master payer list. Select the “Show Products for All Payers” option to show a list of ALL payers in CollaborateMD master payer list, not just your personal payer list. 
  5. To select a payer check the “Sign up for this service” check box displayed besides the payers name. Note: You may select multiple payers and payer types. 

Part 3: 

  1. Here you will be required to answer Form Specific Questions related to each payer within your bundle. 
  2. Important: Please be sure to carefully read the Special Instructions and answer the questions accurately in order to prevent any delays in your approval process. 
  3. All questions presented in this step must be filled out in order to proceed to the next step.
  4. Once you are done, click Next.

Part 4: 

  1. Here you'll be required to enter any additional information pertaining to the payers you selected. Note: Some of the fields on this screen will be automatically populated for you using information already stored in CollaborateMD for the provider that you selected in Step 1
  2. Next, be sure to review the information and fill out any other required fields. 
  3. Click on the Next button. Note: Some fields have specific data formatting requirements. For example, a zip code field may require 5 numeric digits. If you have filled in one or more fields within an invalid data format, you will be presented with a warning message specifying the error or errors and you will be returned to the fields screen. Previously input responses will still be populated and incorrect fields will be highlighted yellow. 
  4. Once you are done, click Next.

Part 5: 

  1. In this step you will see the Review Screen, where you can review the agreements you have completed. 
  2. Click on the Show Instructions button to view the special instructions associated with the payer agreement you selected. 
  3. Next, you can Save to file or Print when the Special Instructions dialogue window opens, click on the Review Form button to review the entries made on the payer agreement. This step is strictly for review purposes. Note: You must proceed to the next step in order to get the completed version of this form. Do NOT fax or mail in this version of the form.
  4. Select Ok and a preview of the agreement will be generated. 
  5. Take this time to review the form for accuracy. If corrections need to be made you may close the form and select the Back button to update any fields/questions. 
  6. If you're satisfied with the agreement, click FinishNoteProceeding to the next step will submit your agreement(s) and you will not be able to change any fields after proceeding. 
  7.  If you’re sure that you want to submit your agreement click Confirm

Part 6: 

  1. This step confirms that you have completed the enrollment process. Please remember that some agreements require you to print and either fax or mail in a signed copy to the Clearinghouse. 
  2. If you are unsure about any of your agreements you can use the Show Instructions option to see any special instructions for the agreement. Forms which are required to be printed, signed, and faxed to the payer will have a status of PRINT
  3. You can access and print the completed form by selecting the Review form button. 
  4. When you are done, select the Done button to start a new enrollment process. 

    Look Up Payer Agreement

    Searching for agreements within the Lookup tab will provide a list of agreements that were completed within CollaborateMD. Each top level node will display the Status and the Date Started of each bundle. Note: These are agreements  that were completed at the same time. In the event the agreement was completed on ConnectCenter , reference the Search Existing Agreement Help Page.

    Once RelayHealth receives the agreement the status will be updated to reflect the current status of the agreement (i.e AuthorizedDenied, Open etc.).For a complete list of all possible agreement status and what they mean, please refer to the Agreement Statuses document.

    Follow the instructions below to look up a previously submitted payer agreement through the CollaborateMD application:

    Note: Only agreements submitted within CollaborateMD and Enrollment Central can be located under the Lookup tab. Agreements previously completed under Collaboration Compass will not appear in the Lookup Tab.
    1. Go to the Payer section.
    2. Select the Agreements tab.
    3. Select the Lookup sub-tab.
    4. Click the magnifying glass within the Provider field and select the provider whose agreements you would like to look up 
    5. Enter your Connect Center Password (if requested).
    6. Click Search to return a list of agreements.
    7. You can refine your search results by using the “Search Criteria” on the left hand pane. You can filter the results by CPID, Payer Name, Products and Status and Date.
    Optional: Click on the Review Form button to open a copy of the agreement. Here you will be allowed to review and print copies of the submitted agreement. 

    Tip: Clicking on the Notes button will open a window that will confirm the status of the agreement and any other pertinent information. 



    Continue Enrollment

    Follow the instructions below to continue a previously saved enrollment form: 
    1. Go to the Payer section.
    2. Select the Agreements tab.
    3. Select the Lookup sub-tab.
    4. Click the magnifying glass within the Provider field and select the provider whose agreements you would like to look up 
    5. Enter your Compass Password (if requested).
    6. Click Search to return a list of agreements.
    7. You can refine your search results by using the “Search Criteria” on the left hand pane. You can filter the results by CPID, Payer Name, Products and Status and Date.
    8. Click on the Continue Enrollment button to continue the enrollment agreement.
    9. Proceed in filling out the agreement. 

    ConnectCenter

    Logging In

    Follow the instructions below to fill out a payer agreement on the ConnectCenter website:

    1. Visit, https://connectcenter.relayhealth.com. Enter your User ID in the field located on the top right corner. NoteYour RelayHealth user ID consists of your Submitter number followed by xgear. Locate your submitter number in the Provider section of the application. 
      • Example: User ID = 123456xgear
    2. If you do not remember your password, a temporary password can be generated by using the Forgot Password function. All users have access to this function. 
      • On the side home page, click the Forgot Password link on the top right of the page
      • Enter your User ID on the Forgot Password page. Click Continue.
      • Answer the password hint question. Click Continue. 
      • A temporary password will be displayed on the screen
      • On the next login, you will be required to change your password, with the following minimum requirements:
        • At least 8 characters
        • One uppercase
        • One lowercase
        • One number
        • One special character such as !@#$%^&*
    3. Agreements MUST be filled out online before you print and mail them. 

    New Agreement

    Follow the instructions below to fill out a new agreement through Enrollment Central:
    1. Click on Payer Tools.
    2. Click on Enrollments.
    3. Click on Go To Start New Enrollments.
    4. Click New Provider.
    5. Enter the NPI and click Validate.
    6. Click Next.
    7. Search for the Payer(s) and products you wish to do an enrollment(s) for.
    8. Once the list of Payer(s) appear, click on the agreement you wish to fill out and drag it to the Selected Payers list on the right hand side. Note: You can select each product you want to do an enrollment for or you can click and drag by the payer name and it will select all products for that payer.  
    9. Once all products are selected, click NextNote: The payers and products will appear on the left. You may remove any enrollments from the bundle by clicking on the box next to the agreement(s) then clicking on Remove Checked. You can also select Save Checked to save the progress on any one of the enrollments you started and continue with the other enrollments in the bundle. 
    10. Take note of the special instructions on the agreement, which are organized by payer, then select Next.
    11. Answer the general and payer specific questions. If you need assistance answering any of the questions, please refer to the Payer Agreement FAQs. Click Next after answering the questions.
    12. To review the forms before submitting, click on the PDF icon next to the agreement you want to review. Note: Do not print this version of the form. This is a draft of the agreement. You must complete the agreement first, then print it.
    13. Once you have reviewed the agreements, click on Complete.
    14. If any forms need to be mailed to RelayHealth, a new window will pop up. Click on Generate Form from that window.
    15. Hover your mouse towards to bottom right of the page, then click on the Print icon.
    16. You will then be asked if the forms successfully printed. If they did not, click No and the forms will open again to allow you to reprint it.
    17. Click Done.
    18. Once the form has been completed, you may be required to print the agreement and mail or fax it to RelayHealth. Important: Please reference the instructions on the cover sheet of the agreement for further instructions on how to submit the agreement to RelayHealth. 

    Search Existing Agreements

    Follow the instructions below to look up a previously submitted payer agreement through the Enrollment Central:

    1. Log on to ConnectCenter at https://connectcenter.relayhealth.com and enter your User ID & PasswordNote: Your user ID consist of your submitter number followed by xgear, for example 123456xgear. The account Administrator should have this information on file. 
    2. Click on Payer Tools.
    3. Click on Enrollments.
    4. Click on Search Submitted Enrollments.
    5. Enter your search parameters. Note: All your agreements under your submitter number will appear if you do not enter any search parameters.
    6. Click Search.
    7. To view the form, click the magnifying glass next to the agreement you wish to view.
    8. Hover your mouse towards the bottom right of the page, then click on the Print icon.
    9. You will then be asked if the forms successfully printed. If they did not, click No and the forms will open again to allow you to reprint them. 
    10. Click Done.
    11. Once the form has been completed, you may be required to print the agreement and mail or fax it to RelayHealth. Important: Please reference the instructions on the cover sheet of the agreement for further instructions on how to submit the agreement to RelayHealth.
    • View: Click on the magnifying glass under View to review your agreement.
    • Provider: Shows the provider the agreement was filled out under.
    • Doc Handle: This is RelayHealth’s reference number for this document.
    • Notes: By clicking on the icon under Notes, it will show denial reasons and any other notes regarding the agreement.
    • Doc Type: This refers to the product that the agreement was filled out for.
    • Status: Shows the status of your agreement.  For a complete list of all the possible agreement statuses and what they mean, please refer to the Agreement Statuses document. 
    • Submitter ID: Lists your submitter number.
    • CPID: Lists the claims processing ID number for the payer the agreement was filled out for.
    • Submitter Name: Lists the name you submitter is registered under.
    • Payer Name: Lists the name of the payer the agreement was filled out for.
    • Date Received: Lists the date that RelayHealth received the hard copy of the agreement.

    Continue an Agreement

    Follow the instructions below to continue an agreement through Enrollment Central:
    1. Log on to ConnectCenter at https://connectcenter.relayhealth.com and enter your User ID & PasswordNote: Your user ID consist of your submitter number followed by xgear, for example 123456xgear. The account Administrator should have this information on file. 
    2. Click on Payer Tools.
    3. Click on Enrollments.
    4. Click on Enrollments in Progress.
    5. Locate the agreement you wish to continue and click on the link in the Step column.
    6. Fill out all the required missing information.
    7. Click on Complete.
    8. If any forms need to be mailed to RelayHealth, a new window will pop up. Click on Generate Forms from that window.
    9. Hover your mouse towards the bottom right of the page, then click on the Print icon.
    10. You will then be asked if the forms successfully printed. If they did not, click No and the forms will open again to allow you to reprint it.
    11. Click Done.
    12. Once the form has been completed, you may be required to print the agreement and mail or fax it to RelayHealth. Important: Please reference the instructions on the cover sheet of the agreement for further instructions on how to submit the agreement to RelayHealth.

    Frequently Asked Questions 

    Visit the Payer Agreement FAQs Help Page to find frequently asked questions.