EDI Portal
EDI Portal Overview
Search Claim History Lookup any patient, submission dates, or date of service to see if your claim has been accepted by the carrier or rejected and why. Many carriers will accept an acknowledgment of acceptance from claims status as proof of timely ...
How to use the EDI Portal
How to use the EDI portal
Print ERA from EDI Portal
Below are the steps to review the ERAs in the EDI Portal and print as needed. 1. Login to ProvideSuite 2. From the Billing Tab 3. Click on EDI Portal 4 .Click the Manage Payments tab 5. Click View Insurance Payments 6. Change the date range as ...
Missing ERA: Portal + Download
If you have received a payment but the Electronic Remittance Advice (ERA) appears to be missing from ProviderSuite, the first step is to confirm that the payer has indeed generated an ERA and sent it to our clearinghouse partner. 1. Confirming if a ...
Missing ERA: Download Only
If an Electronic Remittance Advice (ERA) is listed in the EDI Portal but appears to be missing from ProviderSuite, you can request that the ERA be downloaded in ProviderSuite again. If the ERA is listed and has no “Download Date” or a “Download Date” ...
EDI Portal requesting username
This may be happening because you need to add the TriZetto EDI Portal web site as a trusted site to your computer. You can do this by 1. Clicking on the "Seeing a login screen below? Click here to fix the problem." link under "EDI Portal", 2. ...
EDI Portal Rejection Messages
You can find this information by following these steps: ProviderSuite Billing Tab EDI Portal Manage Claims tab Search Claim History Enter patient info and click create report click on the Date of Service with the rejection message When the new page ...
EDI Portal Payer List
Here are the steps to research payer ID numbers and payer information: Billing Tab select EDI Portal Go to the Resources Tab Select Payer list Now click the Blue link "Professional Payer" Scroll down and in the white box labeled "Payer" enter a payer ...
EDI Portal Enrollment Status
You can find this information by following these steps: Click on the Claims Tab Click on EDI Portal Hover over the "My Account" tab to the right of the page. Select "Manage Practices" Click the " View Enrollment Status" tab to the left of the screen ...
How to Check Patient Eligibility via the EDI Portal
The steps below are for running an eligibility check from the EDI Portal. Go to the Claims Tab Click on EDI Portal Click on Manage Patients Click on Check Patient Eligibility Option Click on "Run indivudual Eligibility Inquiry" Click on Payer or ...
EDI Portal Claim History
The full EDI Rejection messages can be viewed in the EDI portal. Please follow these steps and if you have additional questions please let us know. Go To the Billing Tab Click on EDI Portal Click on the Manage Claims Tab Select Search Claim History ...
Can't access EDI Portal - Confirm TLS settings
If you can't access the EDI Portal page, and you are using Internet Explorer for your web browser, please confirm your browser's Transport Layer Security (TLS) settings. Open Microsoft Internet Explorer Click on Tools Select Internet options Click ...
Report on Claims Printed at Clearinghouse
To generate a report from within the EDI Portal showing the claims sent electronically to the clearinghouse and then printed to paper for delivery to the payer: Login to PracticeAdmin Practice Manager Go to EDI Portal Go to Transaction Summary Report ...
EDI Portal Feature Overview
EDI Portal Feature Overview The EDI Portal is accessed from the ProviderSuite Web Site - Billing tab > EDI Portal The new EDI Portal operates off of tabs, much like PracticeAdmin does. The following information touches on the main features this ...
Popular Articles
EDI Rejection: Medicare only accepts claim frequency code of 1
Medicare does not accept claims marked as corrected or voided. If you have claim rejections for "Medicare only accepts claim frequency code of 1", you will need to re-release the claim and select New, not Corrected or Voided. New should be selected ...
Strategic enrollment manager (STEM) manual and FAQs
Strategic Enrollment Manager (STEM) is a portal within Madaket Health, an enrollment partner of TriZetto Provider Solutions. This portal allows you to: Enter your administrative, practice, provider and payer information for enrollments. View ...
UB-04 facility billing Bill Type - why does it end with 7, instead of 1?
The Bill type is officially a four-digit field, but historically users have known it as a three-digit field, hence the usage of the bill type '711'. If however you print a UB-04 for a claim with a 711 bill type (a new claim), you will see it prints ...
Posting an Unprocessed ERA
Here are the steps to Manually post an Unprocessed ERA. Watch our Training Video. From the Billing Manager > Payment Application > ERA's > Unprocessed> Refresh ERA List> Double Click on the Aetna ERA If the ERA does not need to be posted as it is a ...
Run an ERA Analysis report
Below are the steps to identify payers you are sending claims to, but not receiving remits from. In ProviderSuite, access the EDI portal under the Billing Tab Hover over the "Manage Payments" tab and select "Run ERA analysis". By default, the claim ...