Claims
Clearinghouse integration
ArkCloud talks to a clearinghouse through one thing every clearinghouse offers: an SFTP mailbox. Claims go out as 837P files (837I for a facility that bills on the UB-04); acknowledgements, remittances and 834 enrollment files come back as files. Choosing a clearinghouse is entering its mailbox details, not a code change - and until they are entered, nothing is sent.
Written for: Implementation teams · Platform operators · Billing leadership
Status
How it works
| Field or control | What it means |
|---|---|
| Outbound | Submit to clearinghouse writes one 837P (or 837I) file per claim into the outbound folder, and the daily status and batch eligibility inquiries are written there too, under a temporary name first and then renamed, so the clearinghouse never collects half a file. |
| Inbound | Every 15 minutes, while the background worker is running, it lists the inbound folder and applies each 999, 277, 271 and 835 to the organisation whose claims it names (an 834 enrollment file becomes proposals for staff to approve), then archives it (or deletes it if no archive folder is set). |
| Envelope | The receiver id from the configuration goes in ISA08, GS03 and loop 1000B. The submitter id defaults to the billing provider's NPI. Interchange control numbers come from a database sequence. Outside production the file is marked as a test (ISA15 = T). |
| Security | The server's host-key fingerprint is required. A server whose key does not match is refused before any password or claim is sent. |
| Scope | One mailbox for the whole deployment, shared by every organisation on it. Inbound files are routed by the claim and control numbers they name; a file naming more than one organisation's claims is refused. |
Configure it
- Get SFTP mailbox details from your clearinghouse: host, port, user name, password or private key, the server's host-key fingerprint, the inbound and outbound folders, and the receiver id they expect.Decide the submitter contact phone or email to put in the claim file header - without one every claim is refused.
- A platform operator opens Back office → Credentials → Clearinghouse mailbox (SFTP) and enters them. Practice administrators cannot reach this page: it needs an Administrator who is also listed as a platform operator.
- Use the page's connection test. It connects, verifies the host key, checks that each folder exists and counts the files waiting inbound. Before a fingerprint is entered it reports the key the server presents, without sending credentials, so you can confirm it with the clearinghouse.
- Submit one claim and watch for its 999.
| Field or control | What it means |
|---|---|
| SFTP host, Port | Required host; port 22 when blank. |
| Server host key fingerprint | Required. SHA-256 of the server's key. |
| Username, Password or Private key | Username required. One of password or private key (with an optional passphrase) is required. Secret values are write-only. |
| Outbound directory | Required. Where claims are written. |
| Inbound directory | Required. Where 999, 277, 271, 834 and 835 files are read from. |
| Archive directory | Optional. Processed files move here; blank deletes them. |
| Receiver ID, Receiver name | Receiver ID required (ISA08, GS03, 1000B). Receiver name optional; defaults to the receiver ID. |
| Submitter ID, ISA ID qualifier | Optional. The submitter ID (ISA06, GS02, 1000A) defaults to the billing provider's NPI; the qualifier defaults to ZZ. |
| Submitter contact name, phone, email | The 837 header contact (1000A PER). Name optional; a phone or an email is required, or every claim is refused. |