Claim MD Setup

The purpose of this guide is to walk you through the setup process for submitting claims through Claim MD as the clearinghouse. You should have already received this flyer click here with instructions on how to set up your account, if you have not please contact our team at support@theralytics.net and we can forward it to you.

1. The first step is to create your account with Claim MD. You can use the link in your flyer, or use the link below to create your account (please make sure to use one of these links as it is linked to Theralytics as your vendor).

Theralytics Claim MD Vendor Link

2. Once your account has been created, please log into www.claim.md to create your SFTP credentials.

3. Under Manage Account, go to Settings.

4. Next click Account Settings at the top.

5. Scroll down to the claims section and uncheck “Transmit Approval Required” and “Automatic Corrected Claims”, and enable NCCI.

6. Scroll to the ERA Section and confirm that the following codes are present in the Reject Denials Area

1. CO 45, PR 1, PR 2, PR 3, OA 23, OA 18, CO 223, CO 237

7. Under Claim Alerts, verify that the Alert On section reads “All Claim Issues”.

8. Under SFTP Settings, confirm the SFTP Username and Password. These credentials will need to be sent to your implementation specialist at Theralytics or to our support team at support@theralytics.net to be added to your database.

9. File Acknowledgement should be set to .result, Claim Status Format should be set to 277, and Receive ERA/835 should be set to 835 & PDF.

10. If your agency has  a billing or accounting email, please add that email address to the Invoicing box.

11. The last step is to complete EDI enrollments (if needed) and ERA enrollments for your payers