Claims / Clearinghouses Change Healthcare – The In’s and Out’s

Benefits of Setting up a Clearinghouse

There are two main benefits when connecting a CentralReach account to a clearinghouse. The first, users can send out claims electronically within CentralReach. No need to do this on third-party websites or portals. The second, users can receive payments, in the form of an ERA (electronic remittance advice), directly in their CentralReach account. Users can then view, observe, notate, reconcile and ultimately post payments.

With our clearinghouse partner, Change Healthcare, users have two additional tools to support billing success. Users can electronically verify eligibility, in which they check that a client’s insurance is valid and receive information back from the payor regarding covered services. Users can also complete live claim status checks to find out what is happening with their claim. No need to spend time on the phone with payors, or to do this on payor websites.

Connecting CentralReach to Change Healthcare

To get started please contact your CentralReach account manager and subscribe to Change Healthcare. CentralReach will set up your SFTP gateway in the platform (to send claims and receive ERAs) and will set up your Change Healthcare ConnectCenterTM portal.

Click here to learn how to enroll payors on Change Healthcare.

Click here to learn how to add users to Change Healthcare.

Click here to learn more about Change Healthcare support.

Claims / Clearinghouses Checking Client Eligibility on Change Healthcare

CentralReach users can check client eligibility / insurance verification on the Change Healthcare portal, ConnectCenter. Please log in to the ConnectCenter and click Verification > New Eligibility Requests.  

For step-by-step instructions on the five steps to client eligibility, log in to the ConnectCenter and read the help article here. Please note, Eligibility response data can be viewed and copied in either a human readable or 271 format. Also, eligibility responses can be stored and saved for up to 6 months.

Claims / Clearinghouses / CR Mobile / Electronic Visit Verification (EVV) Tellus – The In’s and Out’s

The Florida Agency for Healthcare Administration’s (AHCA) program has contracted Tellus to be used for Electronic Visit Verification (EVV) in Florida Medicaid regions 9, 10, and 11. CentralReach is integrated with Tellus to support seamless EVV claim submission.

Connecting CentralReach to Tellus

In order to link Tellus to your CentralReach account, providers need to sign up for Tellus, here. A gateway will also be set up in CentralReach for Tellus. Once users have an account with Tellus, they will have access to a portal to view the status of claims in Tellus’ claim dashboard.

Rendered Service Files

CentralReach will send a rendered service file with all required fields to Tellus. The “Responses” section of the Claims Manager will update with an “accepted” or “rejected” status. If the file is accepted, providers can log into Tellus’ portal and release the file for Tellus to generate an 837 claim to send to Medicaid. If the file is rejected, it will state the information that was incorrect. Once the file is corrected, it can be resent to Tellus.

Click here to learn more about CR Mobile and Tellus.