Recent Updates

  • Updated on: Dec 07, 2022

    Appeal/Resubmit a Denied Claim

    Denied claims can be moved to On Hold section of the Claims Manager with a comment or instructions for resubmitting a corrected claim or appealing the determination.

  • Updated on: Dec 07, 2022

    Appeal/Resubmit a Denied Claim

  • Updated on: Dec 07, 2022

    Download and Select Remits

  • Updated on: Dec 07, 2022

    Download and Select Remits

  • Updated on: Dec 07, 2022

    Security for Deleting Remits

    It is recommended that only selected users be allowed to delete remits. If a downloaded remit is inadvertently deleted from Download or Create Insurance Payment list, that remit can be manually selected from the clearinghouse archived remits to download again.

  • Updated on: Dec 07, 2022

    Security for Deleting Remits

  • Updated on: Dec 07, 2022

    Clearinghouse Account Settings

    Remits are generated every 4 hours by Trizetto, placed in a secure-file-transfer-protocol (sftp) and ready to Download at your convenience. Account settings will have to be edited in order to put that automated generation in process.

    When Auto Generate Remittances is checked, any remits without a Download Date will be included in the first download. Remits that should be verified as previously posted will have a yellow background when viewing the downloaded remits list within SOAPware. After verifying a remit has been posted, the remit can be deleted from the list.  

    Remits can also be manually selected for download, if preferred.

  • Updated on: Dec 07, 2022

    Edit Errors

    Electronic Remittance Advice files are matched to the submitted claims within SOAPware. If the ERA returned by a payer doesn't completely match the claim information within SOAPware, the mismatched area will be shaded pink with a tool tip to help identify the error. Once these mismatched items are changed in SOAPware to agree with the information on the remit, future remits for that payer/patient will match and not return with errors.

    • The Post Payment button is not enabled until all errors are corrected.
    • Most errors can be corrected by Matching patients or claims that are shaded pink.
    • If changes are made in patient demographics and Insurance Company setup, to match the way they are returned on the remit, this will reduce the amount of errors for future downloads.
  • Updated on: Dec 07, 2022

    Edit Errors

  • Updated on: Dec 07, 2022

    Insurance Payment Analysis Report