To set up a gateway within CentralReach, you need information from your clearinghouse. To establish an SFTP (Secure File Transfer Protocol) connection between CentralReach and a clearinghouse, contact the clearinghouse customer service department and ask them to activate your account for SFTP. Once that is done, they will send you an email with an SFTP username and password. This is necessary for the connection.
To set up the gateway:
- Navigate to the Claims module and click Settings
- Select Gateways and then you will see an Inactive tab
- Click the inactive tab and then click Activate next to the clearinghouse you want to make active
- Once you have entered the gateway, you will see three tabs: Receiver, Sender, and Submitter
CentralReach sends claims electronically to clearinghouses, using a standard 837P file in a 5010 format that is HIPAA compliant. Return files from the clearinghouses and payors themselves will include 277, 999, and 835 files. Typically, you just need to request the 277 and 999 files be turned on. The 835 sometimes requires enrollment, please confirm if you need to enroll.
277 and 999 – This is an acknowledgment file from the clearinghouse, stating the claim was received, accepted, and sent on to the payor, etc. When calling to activate your account for SFTP, ask your clearinghouse what needs to be done to receive these type of files, such as requesting them to turn this function on.
835/ERA – This is a file from the payor, which will include payment, denial, etc. information. Simply stated, it is an electronic EOB. Contact each of your funding sources to see if they have any requirements before they send 835 files back to your clearinghouse, which in turn is downloaded into CentralReach.
Edit gateway
- SFTP User: normally the username for your clearinghouse account. For example, if you have an Office Ally login, place the username here, not the website username. This is the SFTP username, similar, but different
- SFTP Password: the password you receive from the clearinghouse once you have activated your account for SFTP
- Export: creates a claim file (E.g. 837 file)
- Dropoff: sends claims to a gateway
- Pickup: CentralReach picks up the claims, 835, and ERA files from the clearinghouse
- If this box is unchecked, CentralReach will not attempt to pick up any files from the clearinghouse.
- Also, this is automatically unchecked by the clearinghouse when a connection is turned off, to avoid too many attempts.
- Receiver ID Type (ISA07): the clearinghouse itself and is normally, 30 – U.S. Federal Tax identification number, but you need to confirm. For Waystar (Zirmed), select ZZ – Mutually Defined in the drop-down
- Receiver ID (ISA08): the ID to correlate with the above type. For Waystar (Zirmed), this is the SFTP username
- App Receiver Code (GS03): the ID to correlate with the above type. For Waystar (Zirmed), this is the SFTP username
Sender
- Sender ID Type (ISA05): correlates with how your organization registered with the clearinghouse. It is normally, 30 – U.S. Federal Tax Identification Number, however, you need to confirm with your clearinghouse. For Waystar (Zirmed), select ZZ – Mutually Defined in the drop-down
- Sender ID (ISA06): the ID to correlate with the above type (E.g. Your Tax ID)
- App Sender Code (GS02): the ID to correlate with the above type (E.g. Your Tax ID)
Submitter
- Organization Name (1000A NM103): your organization’s name
- ID (1000A NM 109): your organization’s Tax ID number
- Contact Name (1000A PER02): this is the name of your staff you want to be sent along with the claim, as a contact person
- Phone: contact name’s phone number
- Email: contact name’s email address
The final check:
- Return to the first tab, Edit gateway
- Click on Test the connection, if you do not get confirmation of the connection, there is some type of error
- If you do get confirmation, Save the settings and you are all set to submit via CentralReach
Please note, if you do not already have the 277 and 999 files turned on, begin the process to receive 835/ERA’s, as needed.
