To set up a gateway within CentralReach, information is needed from the 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 completed, they will send an email with an SFTP username and password. This is necessary for the connection.
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, only the 277 and 999 files need to be requested to be turned on. Please confirm if the 835 requires enrollment.
The 277 and 999 are acknowledgment files from the clearinghouse, stating the claim was received, accepted, sent to the payor, etc. When calling to activate the account for SFTP, ask the clearinghouse what needs to be done to receive these types of files, such as requesting them to turn this function on.
The 835/ERA is a file from the payor that includes payment, denial, etc. information. Simply stated, it is an electronic EOB. Contact each funding source to see if they have any requirements before they send 835 files back to your clearinghouse, which in turn is downloaded into CentralReach.
To set up the gateway:
- Navigate to the Claims module and click Settings
- Click Activate next to the clearinghouse to make active
- Click the Journal, Export, Drop off, and Pick up checkboxes as needed
- Gateway name: edit only for generic gateways
- Journal: sends a copy of 837 files to another gateway
- Export: allows users to download a claim file (e.g. 837 file)
- Dropoff: sends claims to a gateway
- Pick up: CentralReach picks up the claim payments (835/ ERA files) and responses from the clearinghouse
- If this box is unchecked, CentralReach will not attempt to pick up any files from the clearinghouse.
- This is automatically unchecked by the clearinghouse when a connection is turned off, to avoid too many attempts.
- Within the “Edit Gateway” tab, complete the Receiver, Sender, Submitter, and Journal tabs:
- Receiver:
- Receiver ID Type (ISA07): the clearinghouse itself and is normally the 30 – U.S. Federal Tax identification number, but this must be confirmed.
- 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 the organization registered with the clearinghouse. It is normally 30 – U.S. Federal Tax Identification Number, but this must be confirmed with the 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. Tax ID)
- App Sender Code (GS02): the ID to correlate with the above type (e.g. Tax ID)
- Submitter:
- Organization Name (1000A NM103): the organization’s name
- ID (1000A NM 109): the organization’s Tax ID number
- Contact Name (1000A PER02): the name of the employee to be sent along with the claim as a contact
- Phone: the contact name’s phone number
- Email: the contact name’s email address
- Journal:
- Click the Send copy to second gateway (journal) checkbox to send a copy of the 837 to another gateway
- Select the second gateway from the Gateway drop-down
- Complete the SFTP Settings tab:
- SFTP user: normally the username from the clearinghouse account.
- For example, with an Office Ally login, place the username here, not the website username.
- SFTP password: the password received from the clearinghouse once the account for SFTP has been activated
- Please note, SFTP credentials cannot be edited without entering your password.
- Click Test Connection & Save. If there is no confirmation for the connection, there is an error.
-