Chapter 13: Agreements & Enrollments
Chapter Overview
What You'll Learn:
- Where Agreements & Enrollments lives for billing-only vs full EMR
- How Betasky sends agreements (Dropbox Sign) and which email receives them
- Exactly what Agency Administrators must do when an email arrives
- What each agreement is (Billing Service, HIPAA BAA, W-9, Ohio EFT)
- Status labels on the page and common stuck cases
Time to Complete: 20–25 minutes to understand
Who Should Read This: Agency Administrators (primary signers) and billing staff who track status
Text-only guide — no screenshots. Follow the exact labels on screen.
This chapter is for agency users. Betasky Super Admin “send / approve” steps are callouts only — never your primary path.
Related: Chapter 14: Go Live (request convert / wipe / approval).
13.1 Where to open Agreements & Enrollments
| Agency type | Environment | Where you open it |
|---|---|---|
| Billing-only | Production (after signup) | SideNav Setup → Agreements → page title Agreements & Enrollments |
| Full EMR | Production (after go-live convert) | Settings → Agreements → Agreements & Enrollments |
| Full EMR | Sandbox | Agreements page is not in Settings. You sign via Dropbox Sign emails during go-live. |
Route for the agency page: /dashboard/agreements.
Do not use Betasky internal Clients → [agency] → Agreements or Go-Live Requests. Those screens are for Betasky staff to send documents and approve go-live. Agency users never navigate there.
13.2 How agreement emails are sent (read this carefully)
Who sends
Betasky staff send each agreement (Billing Service, HIPAA BAA, W-9) from their internal tools.
Agencies do not click a Send button on Agreements & Enrollments.
When Betasky sends a document, the system creates a Dropbox Sign (HelloSign) signature request and emails every required signer.
Which email receives the Dropbox Sign request
Signing emails go to active Agency Administrator login emails — the email each Agency Admin uses to sign in to Betasky.
| Email type | Used for Dropbox Sign? |
|---|---|
| Agency Administrator user email (User Management → that person’s login email) | Yes — this is the signer inbox |
| Agency main / company email (Account Profile company email) | No — business contact only; not used for signing |
| Other staff roles (Biller, Scheduler, RN, etc.) | No — unless that person also has an active Agency Administrator role |
| Inactive / disabled Agency Admin | No — only ACTIVE Agency Administrator assignments |
If your agency has more than one active Agency Administrator, each of them may receive the same Dropbox Sign request (deduped by email). Any one of them can complete the agency signature step.
Common confusion: Agency main email ≠ Agency Admin login email. Check User Management for who has role Agency Administrator and which email they log in with. That is the inbox to watch.
What else is on the signature request
| Document | Who must sign |
|---|---|
| Billing Service Agreement | Every active Agency Admin signer plus a Betasky counter-signer (Betasky’s internal email) |
| HIPAA BAA | Same — Agency Admin(s) plus Betasky counter-signer |
| W-9 Tax Form | Agency Admin signer(s) only (no Betasky counter-sign) |
Until all parties on that request have signed, the card may show PARTIALLY_SIGNED even after you finished your part.
13.3 What is expected from you (Agency Admin) — step by step
When Betasky has sent an agreement:
-
Watch the right inbox
Open the Agency Administrator login email inbox (and spam / junk / promotions). Subject/from will be from Dropbox Sign / HelloSign, not always “Betasky” in the From line. -
Open the email and start signing
Click the secure link in the Dropbox Sign email. Review the PDF, complete any required fields, and Sign. -
Do not ignore PARTIALLY_SIGNED
For Billing and BAA, after you sign, Betasky still counter-signs. Status becomes SIGNED only when everyone on the request is done. You do not need to email Betasky to “finish” unless it stays stuck for a long time. -
Track status in Betasky (when the page is available)
- Billing-only: Setup → Agreements
- Full EMR production: Settings → Agreements
- Full EMR sandbox: email only until after go-live
-
If you never got the email
- Confirm you are listed as Agency Administrator and ACTIVE in User Management
- Confirm the login email is correct (typos block delivery)
- Search spam for Dropbox Sign / HelloSign
- Contact support@betaskyhealth.com or open a Help ticket and ask Betasky to resend — you cannot resend from the agency Agreements page
-
If the wrong person got it / wrong email
Fix the Agency Administrator user email (or assign the correct Admin) in User Management, then ask Betasky support to void and resend. Do not expect the company main email on Account Profile to receive signing links. -
After SIGNED
No further agency action for that document. Keep a mental note of signed date on the Agreements page for audits.
Ohio EFT is different — no Dropbox Sign email. See §13.8 (download packet, wet-ink sign, upload form + voided check on the Agreements page).
13.4 Document matrix
| Document (on-screen label) | Required for go-live / activation? | What agency users do |
|---|---|---|
| Software Order & Billing Service Agreement (or Billing Service Agreement) | Yes | Sign Dropbox Sign email on Agency Admin login inbox; wait for Betasky counter-sign; track status on Agreements & Enrollments |
| HIPAA Business Associate Agreement (BAA) | Yes | Same as Billing |
| W-9 Tax Form | Recommended — does not block approval | Sign Dropbox Sign email (Agency Admin only); track status |
| Ohio EFT Authorization (OBM-4310) | Optional for go-live (needed for Ohio Medicaid EFT into your bank) | On this page: download packet → wet-ink sign → upload signed form → upload voided check |
Page intro copy:
Track your signed agreements and complete payer enrollment steps required to receive electronic Medicaid payments.
If required agreements are unsigned, you may see a warning:
Your Software Order Agreement and HIPAA BAA need to be signed before go-live. Contact Betasky support if you have questions.
13.5 Status labels (Dropbox / agreement cards)
Statuses you may see on Billing, BAA, or W-9 rows:
| Status (examples) | Meaning for agencies |
|---|---|
| Not sent / Draft | Betasky has not sent this document yet |
| Sending to Dropbox… | Send in progress |
| SENT / Waiting | Email sent — check Agency Admin login inbox (and spam) for Dropbox Sign |
| VIEWED | Someone opened the signing link |
| PARTIALLY_SIGNED | You and/or Betasky still waiting — common after you sign Billing/BAA while counter-sign is pending |
| SIGNED | All parties done |
| EXPIRED / VOIDED / DECLINED | Contact Betasky support — do not invent a self-serve resend from Clients |
Agency cards typically show title + status + signed date when available. There is no agency Send W-9 / Send billing agreement button on Agreements & Enrollments.
13.6 Scenario A — Full EMR sandbox go-live
- Agency Admin requests go-live from the sandbox banner (Go Live) — see Chapter 14.
- Betasky staff send Billing Service + HIPAA BAA (and optionally W-9) from their tools.
- You receive Dropbox Sign emails at Agency Administrator login email(s) and sign there (not via Clients; not via company main email).
- After both required agreements are SIGNED (including Betasky counter-sign), Betasky can Approve & activate.
- After convert to production, open Settings → Agreements to track W-9 / Ohio EFT and signed copies.
Sandbox Settings does not show Agreements while you are still in sandbox.
13.7 Scenario B — Billing-only signup
- Sign up via Billing Only on Get Started (
/signup/billing). - Open Setup → Agreements early — this is your home for Betasky Agreements and Ohio EFT.
- Sign Billing + HIPAA BAA via Dropbox Sign when Betasky sends them (Agency Admin login inbox).
- W-9 remains recommended (non-blocking). Complete Ohio EFT on this page if you need Medicaid EFT.
No sandbox demo wipe on billing-only activation — see Chapter 14.
13.8 Scenario C — Production tracking (already live)
Use Agreements & Enrollments to:
- Confirm Billing + BAA show SIGNED
- Finish W-9 if still pending (Dropbox Sign → Agency Admin email)
- Complete Ohio EFT steps if your payers need it
If a document is missing or stuck, contact support@betaskyhealth.com or open a Help ticket — do not look for Super Admin Send buttons.
13.9 Ohio EFT Authorization (OBM-4310) — agency steps
On Agreements & Enrollments, under Ohio EFT Authorization (OBM-4310) — not Dropbox Sign:
- Step 1 — Download your pre-filled packet → Download OBM-4310 packet
Status moves toward Packet Downloaded. - Print, wet-ink sign, then Step 2 — Upload the signed form
After upload, status moves toward Submitted to Payer. - Step 3 — Upload a voided check
Status chips you may see:
| Chip | Meaning |
|---|---|
| Not Started | No packet downloaded yet |
| Packet Downloaded | Packet ready / downloaded |
| Submitted to Payer | Signed form path submitted |
| Approved — EFT Active | EFT enrollment approved |
This flow is separate from the Dropbox Billing/BAA go-live gate. It does not by itself approve go-live.
13.10 W-9 — agency vs Betasky staff
Agency staff
- See W-9 Tax Form on Agreements & Enrollments (recommended, not required for Approve).
- Sign when Dropbox Sign emails your Agency Administrator login address.
- Track SIGNED (or earlier statuses) on the same page.
Betasky staff only (do not tell agencies to do this)
- Send W-9 from internal Clients → [agency] → Agreements
- Send Billing / BAA and Approve from Go-Live Requests
13.11 Common mistakes
- Waiting on the agency main / company email for Dropbox Sign — signing goes to Agency Administrator login emails.
- Looking for Clients → Agreements as an agency user — Betasky Super Admin only.
- Looking for Setup → Agreements on a full EMR agency — that SideNav item is billing-only. Full EMR production uses Settings → Agreements.
- Expecting Agreements under Settings while still in sandbox — hidden until production.
- Assuming W-9 or Ohio EFT must finish before Betasky can Approve — Billing + BAA are the blockers; W-9/EFT are not.
- Thinking you can “Send” agreements yourself from Agreements & Enrollments — agencies sign and track; Betasky sends.
- Panicking at PARTIALLY_SIGNED after you signed Billing/BAA — Betasky counter-sign may still be pending.
13.12 Quick checklist
- Know your path: Setup → Agreements (billing-only) or Settings → Agreements (full EMR production)
- Know your signer inbox: Agency Administrator login email (not company main email)
- Billing + HIPAA BAA signed via Dropbox Sign (and counter-signed) for go-live / activation
- W-9 tracked / signed if your billing team needs it
- Ohio EFT packet + uploads done if you need Medicaid EFT
- Never use Clients / Go-Live Requests as an agency workflow
Previous: Chapter 12: Fee Schedule Setup
Next: Chapter 14: Go Live Process