CollaborateMD: What does each section within the Clearinghouse Connection section of the Payers Setup represent?

Issue

Define each section of the Clearinghouse Connection of Payer Setup.

Environment

CollaborateMD, Payers, Clearinghouse Connection

Resolution

In the Customer Setup under the Payers tab, each payer provides details about supported products based on the payer ID. Below is a breakdown of each section within the Clearinghouse Connection and its meaning:

• Payer ID: The identification number assigned to the payer. This ID is specific to the payer and can typically be found by contacting the payer or checking the back of the patient’s member ID card.
• Clearinghouse ID: The unique ID that links the payer to eProvider Solutions (ePS) for electronic transactions. This is specific to ePS as the current clearinghouse for CollaborateMD.
• Professional Claims: A green checkmark indicates that the payer supports electronic claim submission for Professional claims through the billing software.
• Institutional Claims: A green checkmark indicates that the payer supports electronic claim submission for Institutional claims through the billing software.
• Eligibility: Indicates if the payer supports real-time eligibility checks. This feature must be enabled in CollaborateMD.
  • Note: For more details, refer to Real-Time Patient Eligibility or contact [e-mail] to enable this service. 
• Claim Status: Indicates if the payer supports real-time claim status updates.
  • Note: For more details, refer to Claim Status or contact [e-mail] to enable this service. 
• Electronic Remittance Advice (ERA): Indicates if the payer supports receiving ERAs electronically.
• Accepts Secondary Electronic Claims: Specifies whether the payer accepts secondary claims electronically from the billing software.
• Electronic Claim Attachments: indicates whether the payer allows claim attachments to be submitted electronically alongside the claim.
  • Note: This feature must be activated as service by an Authorized Rep (Kipu Staff). Contact  [e-mail]. For more information, read ePS Claim Attachments

Important: If you see a hyperlink that states Agreement Required, it means an agreement with the payer is needed to submit claims, receive ERAs, or use specific features. For assistance in setting up new ePS payer agreements, refer to New ePS Payer Agreement.

Additional Information

For more detailed instructions and information to understand the clearinghouse connection in payer setup, users can refer to the following articles:

• New ePS Payer Agreement
• Payer & Payer Agreement FAQs
• ePS Claim Attachments
• Claim Status
• Real-Time Patient Eligibility