> ## Documentation Index
> Fetch the complete documentation index at: https://docs.officeridge.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Payer contracts

> Business contracts, managed care agreements, D-SNP plans, and payer open enrolment.

These tabs hold the agreements that let you bill: business contracts, payer agreements, Medicare
Advantage plans, and the enrolment windows you have to apply within.

## Contracts

Business contracts with parties, date ranges, values, and lifecycle status.

**Columns:** Name · Type · Party · Start · End · Value · Status

General business contracts — leases, service agreements, subcontracts.

## Payer Contracts

Managed care and payer contracts with terms, dates, and renewal status.

**Columns:** Payer · Contract # · Type · Start · End · Status

<Warning>
  A lapsed payer contract stops payment for services you may still be delivering. The member's
  authorization can be perfectly valid while the contract behind it has expired. Review **End**
  dates monthly.
</Warning>

The payers themselves are maintained in [Care network](/members/care-network). This tab holds the
commercial agreement behind each one — the **Contract ID** on the payer record links them.

## MA D-SNP Plans

Medicare Advantage Dual Special Needs Plan contracts and enrollment data.

**Columns:** Plan Name · Contract # · PBP · Enrollment · Status

| Field          | What it identifies              |
| -------------- | ------------------------------- |
| **Contract #** | The CMS contract number         |
| **PBP**        | Plan Benefit Package identifier |
| **Enrollment** | Members enrolled under the plan |
| **Status**     | Whether the plan is current     |

D-SNP plans serve members eligible for both Medicare and Medicaid. The contract and PBP combination
identifies the specific plan for billing.

## Open Enrollment

Payer open enrollment periods with application deadlines and submission status.

**Columns:** Payer · Program · Opens · Closes · Status

<Warning>
  **Closes** is a hard deadline. Miss a payer's open enrolment window and you generally wait until
  the next cycle — often a year — before you can contract with them. Track upcoming windows on the
  [compliance calendar](/compliance/quality).
</Warning>

## Renewing a payer contract

<Steps>
  <Step title="Filter on End within 120 days">
    Payer renewals take longer than licence renewals and often involve negotiation.
  </Step>

  <Step title="Confirm prerequisites">
    Payers commonly require current licences, insurance, and accreditation evidence.
  </Step>

  <Step title="Submit the renewal">
    Update status as it progresses.
  </Step>

  <Step title="Record the new terms">
    Update **Contract #**, **Start**, and **End**.
  </Step>

  <Step title="Confirm rates in billing">
    Renegotiated rates affect claim amounts. Check the bill code configuration in
    [EVV matching](/billing/evv-matching).
  </Step>
</Steps>

## Applying during open enrolment

<Steps>
  <Step title="Track upcoming windows">
    Monitor **Opens** and **Closes** by payer and programme.
  </Step>

  <Step title="Prepare the application ahead of the window">
    Assemble licences, insurance, and accreditation evidence before it opens.
  </Step>

  <Step title="Submit well before Closes">
    Late submissions are not accepted.
  </Step>

  <Step title="Record the outcome">
    A successful application becomes a payer contract.
  </Step>
</Steps>

## Troubleshooting

| Problem                                   | What to check                                                                                     |
| ----------------------------------------- | ------------------------------------------------------------------------------------------------- |
| Claims deny despite a valid authorization | Check the payer contract **End** date. An expired contract stops payment.                         |
| A D-SNP claim rejects                     | Confirm **Contract #** and **PBP** match the member's plan exactly.                               |
| We missed an enrolment window             | Record it and track the next **Opens** date.                                                      |
| A payer exists but has no contract        | The payer record and the contract are separate. Create the contract and link via **Contract ID**. |

## Related

<CardGroup cols={2}>
  <Card title="Care network" icon="stethoscope" href="/members/care-network">
    The payer records these contracts sit behind.
  </Card>

  <Card title="Billing" icon="receipt" href="/billing">
    Claims submitted under these contracts.
  </Card>
</CardGroup>