Setup Step 5: Clearinghouse Information

Setup Step 5: Clearinghouse Information

In general you need to pick one clearinghouse to use at a time, although Office Ally is always used as the clearinghouse for some payers.

AdminisTEP

The default clearinghouse used by the system is AdminisTEP because they offer a limited free option. While it will get the job done most of the time, you pretty much get what you pay for.

Availity

Most organizations billing the OKHCA use Availity for their clearinghouse. After creating an Availity account send us the Customer ID, SFTP Username, and SFTP Password. This is required in order to submit claims to Managed Care OKHCA, which has replaced about 85 percent of "Medicaid". 
  1. Go to https://www.availity.com and sign up for a free account. If you already have one you can use it instead. In the future if they require you to upgrade your EDI clearinhhouse account in order to bill the some payers, but for now the free account should be fine.
  2. Click on "Manage My Organization" and note what your Customer ID is.
  3. Click on "FTP and EDI Connection Services" and set up an FTP Mailbox. You might have to reset your password if you don't remember it.
  4. Click on "EDI Reporting Preferences" and under the claims tab deselect anything that is text/human readable and select anything with a number in the name. See attached screenshots for more details.
  5. Email us your Customer ID, FTP username, and FTP password. It may take us a business day to set it up for you.

Office Ally

The general consensus seems to be that Office Ally is better than Availity but more expensive. By default Office Ally is used instead of Availity to submit billing for special payers that are free to bill there but not on Availity using the system's account, even if you have Availity set up as your clearinghouse. You can either use Office Ally as your clearinghouse for all payers or use your Office Ally account instead of the system's account for just those special payers. The main advantage of using your own account is you are able to view those claims there once they are uploaded. To use your own Office Ally account just send us your SFTP Username and SFTP Password and tell us if you want to use it for all payers or just the special payers.