Enrollment Services

Medical and Hospital

Please make your selection from the following available transaction types:

Real-time Enrollment Forms

Real-time functions provide the ability to verify eligibility, check claims status, locate providers, review requests and responses, and make claim-related financial inquiries.

EFT Enrollment Forms (Currently Unavailable - Coming Soon)
ePayment/EFT allows providers to receive payments electronically from payers that have contracted with Change Healthcare to perform this service.

Dental (Currently Unavailable - Coming Soon)

Please make your selection from the available transaction types listed below.

Claims Enrollment Forms (Currently Unavailable - Coming Soon)
Check to see if additional enrollment/registration tasks are required by the payer prior to accepting claims electronically.

ERA Enrollment Forms (Currently Unavailable - Coming Soon)
Check to see if additional enrollment/registration tasks are required by Change Healthcare and/or the payer prior to delivery of ERA/835 transactions.

Real-time Enrollment Forms (Currently Unavailable - Coming Soon)
Check to see if additional enrollment/registration tasks are required by the payer prior to accepting 270 Real-time Eligibility Inquiry transactions.

EFT Enrollment Forms (Currently Unavailable - Coming Soon)
Dental providers may enroll to receive EFT payments from the numerous payers who have partnered with Change Healthcare within their Dental Connect for Providers account.