Solutions 

E1 Submission Agreement for B1 to E1 Mapping

Part A/B with B1 Mapping

If you do not have switching service with RelayHealth, then contact your vendor or switch.

If you have an agreement with RelayHealth for switching services, you must submit a new amendment for the Eligibility services. The Facilitator has a standard contract that enables the pharmacy and Facilitator to participate in these services.

If you currently have switching service with RelayHealth and you are a Chain, Vendor, or Independent then, follow the directions below to submit a new agreement.

Part A/B Mapping Eligibility Facilitation Service Amendment Submission

  1. Print and complete the Medicare eligibility amendments Part A and B implementation form in its entirety, either on-line or by hand.
  2. Print and sign two copies of the Part A and B eligibility facilitation with B1 mapping service amendment.
  3. Mail all three documents to our Legal Department at:
    RelayHealth
    Attn: Legal Department
    1564 Northeast Expressway NE
    Atlanta, GA 30329

Both Part A/B Mapping Eligibility Services Amendments must have a handwritten signature.

If you have any questions or need additional information, please contact our Customer Support Center at 1-800-388-2316.

Part D with B1 Mapping

If you do not have switching service with RelayHealth, then contact your vendor or switch.

If you have an agreement with RelayHealth for switching services, you must submit a new amendment for the Eligibility services. The Facilitator has a standard contract that enables the pharmacy and Facilitator to participate in these services.

If you currently have switching service with RelayHealth and you are a Chain, Vendor, or Independent then, follow the directions below to submit a new agreement.

Part D Mapping Eligibility Facilitation Service Amendment Submission

  1. Print and complete the Medicare eligibility amendments Part D implementation form in its entirety, either on-line or by hand.
  2. Print and sign two copies of the Part D eligibility facilitation with B1 mapping service amendment.
  3. Mail all three documents to our Legal Department at:
    RelayHealth
    Attn: Legal Department
    1564 Northeast Expressway NE
    Atlanta, GA 30329

Both of the Part D Mapping Eligibility Services Amendments must have a handwritten signature.

If you have any questions or need additional information, please contact our Customer Support Center at 1-800-388-2316.

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