Change of Vendor form?
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Hi, how do I create a "change of vendor" (COV) form/letter?  Please see context below.  I am trying to receive ERAs for United HealthCare/Optum through Simple practice instead of through my former online billing service.

Thanks!

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Hi Sarah Parsons,

Your payment report enrollment for payer 'United HealthCare' was rejected for the following reason(s):

  • The payer rejected the enrollment due to the provider is linked to another clearinghouse to receive ERAs. Please ask the provider to submit the COV (change of vendor).

Please correct this information. If necessary, contact this payer to verify the information on your enrollment and re-submit.

Our support team doesn't have the ability to provide more information for rejected enrollments.

The enrollment transaction reference ID is 247198513 with NPI number 1679729677.

5 comments

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    Denise Hutchins

    Hi Sarah!  I just did my letter today!  Optum is sneaky with getting you to sign up with their vendor, Payspan.  So, if you can provide me your email address, I'll send you a (redacted) copy of what I used.

     

    Denise

    Hi Sarah!  I just did my letter today!  Optum is sneaky with getting you to sign up with their vendor, Payspan.  So, if you can provide me your email address, I'll send you a (redacted) copy of what I used.

     

    Denise

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    Lori Capone

    HI

    I have had similar issues. Can I have a copy of the letter as well?

     

    HI

    I have had similar issues. Can I have a copy of the letter as well?

     

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    Monika

    Hi,

    An enrollment can be rejected if it's linked to a different clearinghouse. If you received a rejection message: "The payer rejected the enrollment due to the provider is linked to another clearinghouse to receive ERAs. Please ask the provider to submit the COV (change of vendor)."

    In this case, please contact our team is for additional assistance with your Change of Vendor (COV) form, including submitting this COV in order to switch you back to our clearinghouse (Eligible).

    However, if your curious to what a COV looks like, see below for an example to United HealthCare:

    At the top, include your nameaddress, and today's date. Then you'll need to include the following:

    "Please update my enrollment with United HealthCare to receive payment reports through SimplePractice. Below is the requested information:

    • TIN: [Insert you Tax ID]
    • NPI: [Insert you NPI]
    • Payer Name: UnitedHealthCare
    • Payer ID:  87726
    • Clearinghouse / Company Name / User Id: Eligible, inc. GATE0164"

    Lastly, you'll want to sign the bottom of this letter and print your name.

    Let us know if you have any additional questions, we're here to help.

     

     

     

    Edited by Monika

    Hi,

    An enrollment can be rejected if it's linked to a different clearinghouse. If you received a rejection message: "The payer rejected the enrollment due to the provider is linked to another clearinghouse to receive ERAs. Please ask the provider to submit the COV (change of vendor)."

    In this case, please contact our team is for additional assistance with your Change of Vendor (COV) form, including submitting this COV in order to switch you back to our clearinghouse (Eligible).

    However, if your curious to what a COV looks like, see below for an example to United HealthCare:

    At the top, include your nameaddress, and today's date. Then you'll need to include the following:

    "Please update my enrollment with United HealthCare to receive payment reports through SimplePractice. Below is the requested information:

    • TIN: [Insert you Tax ID]
    • NPI: [Insert you NPI]
    • Payer Name: UnitedHealthCare
    • Payer ID:  87726
    • Clearinghouse / Company Name / User Id: Eligible, inc. GATE0164"

    Lastly, you'll want to sign the bottom of this letter and print your name.

    Let us know if you have any additional questions, we're here to help.

     

     

     

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    Elizabeth Wilmer

    This same issue occurred with me today. I am switching from MCP to SP and Optum/UHC stated that they rejected it and that I had to send a change of vendor request. Thank you for the above example. What address do I send the above letter to?

    Thank you, 

    Elizabeth Wilmer

    This same issue occurred with me today. I am switching from MCP to SP and Optum/UHC stated that they rejected it and that I had to send a change of vendor request. Thank you for the above example. What address do I send the above letter to?

    Thank you, 

    Elizabeth Wilmer

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    Gillian

    Hi Elizabeth, you'll want to reach out to Optum/UHC directly to confirm the correct address or fax number to send this form to. 

    Hi Elizabeth, you'll want to reach out to Optum/UHC directly to confirm the correct address or fax number to send this form to.