CentralReach electronic claim services allow you to send claims electronically to most commercial insurance companies and government payers. This process dramatically reduces the data entry error and speeds. In order to use CentralReach’s electronic claims submission, administrators need to complete enrollment agreements with their payors for electronic submission where necessary. Please contact each of your payors to determine if electronic claim submission registration is required. Once those are complete, administrators should contact their preferred Clearinghouse to subscribe to their submission services.
Step 1 – Enroll with Payor
Complete payer specific enrollment agreements. These are sent directly to the insurance company or government agency (not CentralReach or clearinghouse). Many payors will accept electronic claims submission directly from the provider using our 837P format, others may require submission through a Clearinghouse.
Step 2 – Enroll with Clearinghouse Vendor
Current supported clearing houses include: Office Ally, Zirmed.
Office Ally Enrollment Information
Register with clearing house for claims submission. This service is free as long as 50% or less of claims are non-governmental. Enrollment can be completed online by visiting http://www.officeally.com/register/enrollment.aspx.
When signing up for OfficeAlly and stipulating the types of claims you will be submitting, please make sure to designate one claim type. The recommended claim type would be 837P Medical.
Once your initial Office Ally enrollment is complete and you have received your account you’ll need to call Office Ally’s customer service line at 360-975-7000 option 1 and ask them to activate your account for Secure File Transfer Protocol (SFTP). This normally takes 24 to 48 hours and once complete you will receive an email from Office Ally with your SFTP username and another email with your SFTP password.
ZirMed Enrollment Information
To enroll with ZirMed’s clearinghouse services you must first call their dedicated sales line at 877-995-9557. They will review pricing and services and provide enrollment forms with instructions. Once enrollment is complete they will provide you with both an SFTP username and password.
Availity Enrollment Information
To enroll with Availity clearinghouse services you must first contact Christopher Plante, firstname.lastname@example.org.
Step 3 – Claims Manager Settings
Once you have received your SFTP information from the clearinghouse the next step is to update your claims manager settings. To do so scroll over the claims icon and click settings. Click the ‘Gateways’ tab from the left hand side to begin inputting your SFTP information.
Any questions or concerns on the Claims Submission process, please contact Customer Care using the Ticket System in your account.
Step 4 – Electronic Remittance Advise (835) Files
Once you have set-up your Gateway, you are able to begin the claims submission process. In order to receive responses or payment information, the user must contact the payor to request that the 835 files be returned to the Clearinghouse. Most clearinghouses will provide payor enrollment forms as a resource.