Clearinghouse: Change Healthcare


TherapyNotes works with our clearinghouse partner Change Healthcare to submit insurance claims and receive electronic remittance advice (ERA). Change Healthcare supports claim submission to over 2,000 payers nationwide, and any practice can enroll to submit electronic claims and receive ERAs through TherapyNotes at no additional cost. For more information on enrollments, read Electronic (EDI) Claims Enrollment and Electronic Remittance Advice (ERA) Enrollment.

To learn which payers Change Healthcare works with, read Payers Supported by Clearinghouse. While Change Healthcare has relationships with over 2,000 payers, not every existing payer is supported. If you work with a payer who is not supported by Change Healthcare, read No Payer ID to learn how to handle claims for the payer.

Role of the Clearinghouse

Whenever you submit an electronic claim through TherapyNotes, the claim is processed by our clearinghouse before it is sent to the payer. The clearinghouse reviews the claim for missing information or errors before translating the claim to the appropriate format for the specific insurance company. If the clearinghouse does detect any errors, they will reject the claim and push a notification into TherapyNotes to inform you that the claim was rejected. To learn how to resubmit rejected claims, read How To: Resubmit EDI Claims.

It can take about 24 hours for the clearinghouse to receive claims submitted through TherapyNotes and between 24 and 48 hours for the clearinghouse to review the claim and send it to the payer. Once in the payer’s hands, the amount of time the payer takes to process the claim and provide reimbursement varies. Many payers send updates on the status of the claim through the clearinghouse to TherapyNotes, including notifications that the claim was received, accepted into the adjudication system, or rejected for errors.

Once processed, the payer will send a paper check to the address entered in your Practice Information (User Icon > Settings > Practice Information) or your Alternate Billing Address, if applicable (User Icon > Settings > Practice Billing Settings). If you have electronic funds transfer (EFT) set up with the payer, you will receive reimbursement according to the method and terms set up with the payer. Please contact the payer directly to set up EFT.

Contacting the Clearinghouse

TherapyNotes users typically do not need to interact with the clearinghouse. If you have an issue with a rejected claim or receiving ERAs, please contact the TherapyNotes support team, and we will contact the clearinghouse on your behalf.

Clearinghouse Costs

There is no cost to enroll to submit electronic claims or receive ERAs. With the appropriate enrollments completed, TherapyNotes charges $0.14 per electronic claim and $0.14 per ERA, which is less than the cost of a stamp.

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    I see you had an open ticket with one of our support team members for the above ticket. I will have him reach out to you in regards to that. Thank you.

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    Eden Davisson

    Hi there, when I used therapynotes to enroll in billing through the clearinghouse (for BCBS), I was linked to two applications to fill out. One for Emdeon and one for BCBS. I understand there was a name change from Emdeon to ChangeHealthcare, and I see online that there is a changehealthcare form identical to the emdeon form, but with the new name. My concern is that the link to the Emdeon form may not be up to date. Date of last revision to that form was 4/11/14. Should I fill it out, anyway?

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    Sean Behan

    Hi Eden,

    The forms in TherapyNotes are correct. Please fill out both forms and submit as indicated. As Change Healthcare updates their forms to their new name, TherapyNotes will change the enrollment paperwork for each payer. Please let us know if you have any other questions. Thank you.

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    Kelly Carpenter

    We are experiencing problems with America's PPO. They are needing information about the specific insurance company that we are billing as they too are a clearinghouse. Where can we submit the information for specific insurance companies?

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    Kelly Carpenter

    Also, having problems submitting claims through a number of insurance companies that require NPIs specific to the renderring provider. This information has been submitted with our EDIs but is not getting passed to them along the correct avenues. Please help solve these problems. Thank you.

    Edited by Kelly Carpenter
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    I'm going to reach out to you in regards to your inquires about billing. Thank you.

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    Daniel Winarick

    Code 19: claim requires use of an “entity code”

    In the context of a claim submitted to an out of network payer PPO plan, I have received this ERA and would be grateful for any clarification on what it means, why, and how it can be addressed. Thanks!

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    We will have an agent reach out to you directly regarding this. Thank you.