Clearinghouses

This page will walk the user through how to setup their clearing how in the TRAKnet application.

Clearing Houses

The clearing houses can be found on the Properties page under insurances. The button to open the Clearing Houses pop up will be in the upper right hand corner of the Insurances screen.

Properties.png

On the Clearing houses pop up there will be two tabs; The first one is for Availity and the second one is for Gateway.

Availity

The Availity tab will contain all of the connection information for submitting claims and Statements through Availity.

AvailityClearin.png
  • EDI No – is the EDI number associated with the Availity account.
  • Submitter Phone – The phone number of the primary individual submitting claims.
  • Submitter Contact – The name of the primary individual submitting claims.
  • SFTP Site – The site claims, statements and remits will be sent to and received from.
  • SFTP User Name – The user name associated with the SFTP site.
  • SFTP Password – The password associated with the SFTP site.
  • Eligibility User Name – The user name associated with the Eligibility account.
  • Eligibility Password – The password associated with the Eligibility account.
  • Use Automated Secondary Claims – Setting this option to True will send secondary claims automatically when primary claims are sent.
  • Batch Eligibility Provider - The default provider used for batch eligibility checks.
  • Use Availity Statements – TRAKnet will sent statements through Availity when this is set to True.

Gateway

The Gateway tab will contain all of the connection information for submitting claims and Statements through TriZetto’s Gateway Site.

Gateway.png
  • EDI No –- This number will be your Gateway site ID.
  • Submitter Phone -– This number will be the phone number of the user who is submitting claims.
  • Submitter Contact –- This will be the name of the user who is submitting claims.
  • Use Automated Secondary Claims -– Setting this option to True will send secondary claims automatically when primary claims are sent.
  • FTP Site — This will always be ftp.gatewayedi.com/.
  • User Name –- This will be your Gateway Site ID.
  • Password –- This will be your FTP password as provided by Gateway EDI.
  • Website Password –- This will be your website password as provided by Gateway EDI.
  • Batch Eligibility Provider — The default provider used for batch eligibility checks.
  • Use Gateway EDI Statements — A true or false setting. If true, statements can be sent to Gateway EDI.
  • Statement Type – This option will determine if detailed statements or simple statements are sent to Gateway EDI when using the electronic statements feature.
  • Use .BAT file encryption — This option will determine whether claims are encrypted with a local batch file or with TRAKnet's own coded encryption.

Statements

Statements can be sent to the clearing house of your choice within the TRAKnet application.

To send statements to your clearing house out sourcing of the mailing process you must first decide which clearing house the statements will be sent to.

  1. Go to Tools and select Options
  2. Find Patient Statements and click the arrow to expand the category.
  3. Under Statements Clearinghouse choose the desired clearinghouse.
Options.png

After you have chosen the clearinghouse in options you will need to verify the clearinghouse is set to send claim.

  1. Go to Properties and click on Insurances
  2. Open the Clearinghouse window by clicking the Clearinghouse button in the top Right-hand corner.
  3. Select the tab of the desired clearinghouse and set the statement line to True
    • Use Gateway EDI statements – for Gateway clearinghouse
    • Use Availity Statements – For Availity clearing house.
AvailityClearin.png

Once you have set your statements clearing house statements will be sent to the selected clearing house when exported.
For a walk through on how to print and export statements please click here(Link to statements).

Additional Material

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