Activating the Third-Party Billing Integration

For electronic third-party billing, you can use either of the following electronic data interchanges:

  • Gateway EDI: Files are submitted automatically by Eyefinity Practice Management to TriZetto/Gateway.
    • Before you can use TriZetto, you must contact Eyefinity Customer Support to perform the initial setup.
  • Standard EDI: Files are not submitted automatically. You must download the file and then upload it to your clearinghouse’s website.

Once you enter your EDI Site Key, you can then activate electronic claim submissions for individual carriers in Carrier & Plan Setup. For more information, go to Enabling Electronic Claim Submissions for Carriers. For information on billing claims using the integration, go to Billing Claims Through TriZetto (Gateway EDI) and Billing Claims Through Standard EDI. For information on using the TriZetto eligibility integration, see Adding Eligibilities Using the TriZetto Integration.

  • Eyefinity recommends you process any outstanding claims for your current EDI receiver before selecting a different receiver.
  • Settings made on the Insurance Integrations page in Company: Setup apply to all offices in your company, but you can set up separate Gateway EDI Site Keys for individual offices. The office Site Key overrides the company Site Key when billing claims. For more information, go to Setting Up Gateway EDI Site Keys for Individual Offices.

To activate the third-party billing integration:

  1. From the menu, click Billing & MVC and then select Insurance Integrations.
  2. Under Third Party Billing, select the EDI Receiver.
  3. Enter the receiver information you received from the clearinghouse.
  4. Click Save.

    5. Go to Enabling Electronic Claim Submissions for Carriers to activate electronic claim submissions for individual carriers.