Electronic Billing Services (EDI, ERA, EFT)
Keystone First contracts with Change Healthcare — one of the largest electronic data interchange (EDI) clearinghouses in the country — to offer state-of-the-art EDI and other electronic billing services. Using EDI services can make the claims submission and reimbursement processes more efficient, and enhance your revenue cycle.
Electronic claims submission
Keystone First claims can be submitted electronically through Change Healthcare, or another clearinghouse. Contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic claim submissions to Keystone First.
Keystone First does not require you to enroll with Change Healthcare to submit electronic claims. If you already use another EDI vendor to submit claims electronically, give your vendor the Keystone First EDI payer ID: 23284.
Submission via Change Healthcare
Providers can submit claims directly to Change Healthcare through WebConnect. This service provides two methods for submitting claims: Key them in manually or import batches of claims. There is no cost to manually key claims in using WebConnect, but claims must be entered one at a time, which may not be feasible for practices with high claim volume. Practices that choose to import batches of claims via WebConnect should be aware that there is a one-time setup fee of $300 for this service.
Providers should call 1-877-667-1512 and follow the appropriate prompts, or go to Change Healthcare WebConnect to enroll for direct submission. Change Healthcare will also provide information on their various electronic solutions, the requirements for connectivity, and setup instructions.
Electronic claim payment options
Change Healthcare is partnering with ECHO Health Inc. (ECHO Health), a leading innovator in electronic payment solutions, to offer more electronic payment options to our health care providers. You can select the payment method that best suits your accounts receivable workflow.
Virtual credit card (VCC)
ECHO Health offers virtual credit cards as an optional payment method. Virtual credit cards are randomly generated, temporary credit card numbers that are either faxed or mailed to providers for claims reimbursement. VCC payments have a number of advantages for providers:
- You do not have to enroll or fill out multiple forms in order to receive VCC.
- We will never request personal information, such as practice bank account information.
- You can access your payment the day you receive the VCC.
In the future, Keystone First providers who are not currently registered to receive payments electronically will receive VCC payments as their default payment method, instead of paper checks. Your office will receive either faxed or mailed VCC payments, each containing a VCC with a number unique to that payment transaction, an instruction page for processing, and a detailed Explanation of Payment /Remittance Advice (EOP/RA). Normal transaction fees apply based on your merchant acquirer relationship. If you do not wish to receive your claim payments through VCC, you can opt out by contacting ECHO Health at 1-888-492-5579.
Electronic funds transfers (EFT)
Electronic funds transfers allow you to receive your payments directly in the bank account you designate rather than receiving them by VCC or paper check. When you enroll in EFT, you will automatically receive electronic remittance advices (ERAs) for those payments. All generated ERAs and a detailed explanation of payment for each transaction will also be available on the ECHO provider portal (http://www.providerpayments.com). If you are new to EFT, you will need to enroll with ECHO Health for EFT from Keystone First.
Please note: Payment will appear on your bank statement from PNC Bank and ECHO as “PNC — ECHO.”
To sign up to receive EFT from Keystone First, visit https://enrollments.ECHOhealthinc.com/efteradirect/enroll. There is no fee for this service.
To sign up to receive EFT from all of your payers that process payments on the Settlement Advocate platform, visit https://enrollments.ECHOhealthinc.com A fee for this service may be required.
If you have questions on how to enroll in EFT, please see the Keystone First EFT Enrollment Guide (PDF).
Electronic remittance advice (ERA)
Keystone First now also offers ERAs (also referred to as an 835 file) through Change Healthcare and ECHO Health. To receive ERAs from Change Healthcare and ECHO, you will need to include both the Change Healthcare Keystone First payer ID 23284 and the ECHO payer ID 58379. Contact your practice management or hospital information system vendor for instructions on how to receive ERAs from Keystone First under Payer ID 23284 and the ECHO Payer ID 58379. If your practice management or hospital information system is already set up to accept ERAs from Keystone First, then it is important to check that the system includes both Keystone First payer ID 23284 and the ECHO Payer ID 58379 for ERAs.
If you are not receiving any payer ERAs, please contact your current practice management or hospital information system vendor to inquire if your software has the ability to process ERAs. Your software vendor is then responsible for contacting Change Healthcare to enroll you for ERAs under the Keystone First payer ID 23284 and the ECHO Health Payer ID 58379.
If your software does not support ERAs or you continue to reconcile manually, and you would like to start receiving ERAs only, please contact the ECHO Health enrollment team at 1-888-834-3511.
For enrollment support, please contact ECHO Health at 1-888-834-3511.
If you have additional questions regarding VCC, EFT, or ERAs, please see our FAQ (PDF) or call the Echo Health support team at 1-888-492-5579.