Managing Clearing Houses :

Introduction

ElderSuite is Elder Care Management Software for Adult Day Care and other Elder Care Service providers. ElderSuite generates HIPAA compliant transactions and submits those transactions electronically to a clearinghouse for further processing. Your organization will need to have an account with any clearinghouse(s) through which you wish to submit claims electronically. ElderSuite will only submit claims electronically through a clearinghouse and will not submit claims directly to payers. Currently, ElderSuite is partner with the following clearinghouses:


Availity	Texas Medicaid & Healthcare Partnership

Please Note: Ensure you have setup accounts with these any of the clearinghouses above through which you wish to submit claims.

Managing Clearing House Settings

Step 1

The clearinghouse settings can be accessed in the Claim Center. To display the Claim Center, use your mouse to click the Claim Center button on ElderSuite's Navigation Bar as pointed out in the image below.

Step 2

After the Claim Center is displayed, use your mouse to click the Manage Clearing Houses link located in the Related Activities panel as pointed out in the image below.

Step 3

After the Clearing Houses List is displayed, you use your mouse to select the Clearing House you would like to manage in the list as shown in the image below. After you have selected the desired record you can click the Edit button on the menu bar or you can simply double-click the record.

Step 4

The desired Clearing Houses will displayed in the Clearing House Information window. You are only allowed to edit the Username and Password fields. In those fields you can input the credentials provided to you by the selected clearing house. These credentials will allow ElderSuite to connect to the clearing house electronically to send and receive HIPAA compliant transactions.

Please Note: The credentials you receive from Availity are referred to as an SFTP User Name and Password. The credentials you will received from TMHP (Texas Medicaid & Healthcare Partnership) are referred to as a Submitter ID and Password.

Step 5

After you have input your credentials you can click the Test Connection button located on the menu and pointed out in the image blow. This will allow ElderSuite to attempt a connection using the credentials you provided.

If the credentials were input correctly and there are no problems with your clearing house account you will receive a notification telling the that ElderSuite "Connected Successfully" as shown in the image below.

If the credentials were input incorrectly you will receive a notification explaining that "Your User Name or password is invalid" as shown in the image below. If you receive any other message then there is something wrong with the clearing house account and how it was setup. You would need to contact the clearing house to resolve the issue.

Please Note: If you are connecting to TMHP (Texas Medicaid & Healthcare Partnership, you will first be required to connect to TMHP via a VPN (Virtual Private Nework). You must establish this VPN connection with software provided by TMHP, the Cisco Anyconnect Secure Mobility Client. Additional Information regarding this software can be found on page 8 of the TMHP EDI Connectivity Guide. This guide is located on their website here: TMHP EDI Connectivity Guide.

Step 6

After you are finished you can save those changes and close the Clearing House Information window by clicking the Save & Close button as shown in the image below.