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MEDICAID NEW JERSEY (MCD NJ) ENROLLMENT INSTRUCTIONS WHICH FORM(S) SHOULD I DO? Submitter/Provider Relationship EDI Agreement o Instructions can be found on pages 26 o This form has to be sent to

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How to fill out change healthcare era enrollment

01

Start by visiting the Change Healthcare website.

02

Locate the 'Enrollment' tab on the website and click on it.

03

Fill out the required personal information fields, including your name, contact number, and email address.

04

Provide your current healthcare information, including your insurance provider, policy number, and group number.

05

Review the enrollment form for any errors or missing information.

06

Submit the completed enrollment form online.

07

Wait for confirmation of enrollment from Change Healthcare via email or phone.

08

Keep a copy of the completed enrollment form for your records.

Who needs change healthcare era enrollment?

01

Anyone who wants to avail the services provided by Change Healthcare and wishes to enroll in their program needs to fill out the Change Healthcare era enrollment form.

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What is change healthcare era enrollment?

Change Healthcare ERA enrollment is the process through which healthcare providers enroll to receive Electronic Remittance Advice (ERA) from Change Healthcare, which provides details on claims adjudication and payment information.

Who is required to file change healthcare era enrollment?

Healthcare providers and organizations that wish to receive electronic remittance advice for their claims submissions must file for Change Healthcare ERA enrollment.

How to fill out change healthcare era enrollment?

To fill out Change Healthcare ERA enrollment, providers typically need to complete an online application or form provided by Change Healthcare, including necessary information such as provider details, NPI number, and billing information.

What is the purpose of change healthcare era enrollment?

The purpose of Change Healthcare ERA enrollment is to ensure that healthcare providers can electronically receive and manage their payment details and information regarding claims from Change Healthcare effectively.

What information must be reported on change healthcare era enrollment?

Information required on Change Healthcare ERA enrollment includes provider name, National Provider Identifier (NPI), Tax Identification Number (TIN), contact information, and specific details pertinent to the billing process.

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