4. Setting Default Claim Options/Base Export Path

Setup how paper and electronic claims are exported from the system.

Tools -> Billing Maintenance -> Claims Options

Paper Claim Options

Paper Claim Options

1. Default Printer: Select from the dropdown to set the default printer when printed paper claims.  

2. Print Full CMS Form: If not using preprinted CMS 1500 form, check Print Full CMS form to print the entire claim form, including the red lines (must have color printer).

Electronic Claim Options

Electronic Claim Options

1.  *Office Contact: Enter the Contact Name for the person in the office who will be the contact for Gateway EDI, if any issues arise.

2.  *Office Contact Phone: Enter the Contact Phone Number for the person in the office who will be the Gateway EDI contact.

3.  Output Path: Specify a file location to which claims will be exported. Note: Make sure that the Save Local Copy box is checked to save your claim files to a local file. If more than one person in the office works with claims, it is recommended that this file path be stored in a shared file/drive to allow multiple people to access the claim files.

4.  Auto Submit: If this box is checked, electronic claim files will be automatically uploaded to the clinic Gateway EDI site. You will have to have the correct information entered in the Clearinghouse fields in the section below to ensure this will work correctly. If you would like to manually save and upload claim files to Gateway EDI, uncheck this box.

5. Save Local Copy: Check this box if you would like to store a copy of your claim files on a local drive/file location. If you have Auto Submit and Save Local Copy checked, you will be able to both auto submit your files to Gateway EDI, and you will have the claim file stored in a local drive, in case any discrepancy comes up, and the file needs to be re-uploaded.

1. Name: Indicates the name of the Clearinghouse.

2. Clearinghouse ID: If using Gateway EDI as your clearinghouse, enter the following number in this field: 431420764

3. Receiver Qualifier: If using Gateway EDI as your clearinghouse, select Mutually Defined - ZZ from the dropdown list.

4. Receiver ID: If using Gateway EDI as your clearinghouse, enter the following number: 431420764000000

5. User Name: Enter the 4 digit site ID assigned to your clinic by Gateway EDI.

6. Password: This password will be given to you by Gateway EDI. This will be the needed password to auto submit your claim files using their sftp site.

7. Server: If using Gateway EDI as your clearinghouse, enter the following: sftp.gatewayedi.com

8. Testing: Only check this box if you are wanting to send a test file to Gateway EDI. IMPORTANT: For your first claim submission to Gateway EDI, do not check this box. Gateway prefers to have live claims sent to them. They will manually review the file first, and if everything looks good, they will forward on to payers.

9. Accept Assignment: Check this box if you would like to default to Accept Assignment on all claims. It can be overriden at the Insurance Company and claim level, if needed.

10. Click Okay to save.